Mamdouhi, Kevan John

Mamdouhi, Kevan John is an individual health care provider with primary practice located at 41 Mall Rd , Burlington MA 01805-0002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Medical Toxicology, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Mamdouhi, Kevan John can be contacted via phone (781) 744-8000.

Contact Information

Primary practice address
41 Mall Rd Burlington MA 01805-0002
Phone: (781) 744-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Toxicology 207PT0002X 290694 Massachusetts
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 290694 Massachusetts

Profile Details

NPI number 1013477512
LBN Legal business name Mamdouhi, Kevan John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2019
Last updated Oct 22nd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013477512 NPPES
Massachusetts MEDICAID 110153881A

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