| Wissam Khoory, Md,pc | |
|
20 Hope Ave Suite G03 Waltham MA 02453-2721 | |
| (781) 893-4490 | |
| (781) 893-1030 |
| Full Name | Wissam Khoory, Md,pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 20 Hope Ave, Waltham, Massachusetts |
| Authorized Official Name and Position | Michelle Cormier (SECRETARY) |
| Authorized Official Contact | 7818934490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wissam Khoory, Md,pc 20 Hope Ave Suite G03 Waltham MA 02453-2721 Ph: (781) 893-4490 | Wissam Khoory, Md,pc 20 Hope Ave Suite G03 Waltham MA 02453-2721 Ph: (781) 893-4490 |
| NPI Number | 1205008141 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 04/01/2008 |
| Medicare PECOS PAC ID | 1355534561 |
|---|---|
| Medicare Enrollment ID | O20101020001013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205008141 | NPI | - | NPPES |
| J18529 | Other | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 153969 (Massachusetts) | Primary |
| Provider Name | Wissam J Khoory |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013962430 PECOS PAC ID: 7911190111 Enrollment ID: I20101020000826 |
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