| Organization Name: | DR. ESSAM KHEDR, DPM, LLC |
| NPI Number: | 1376834515 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ESSAM KHEDR (PODIATRY PHYSICIAN) |
| Mailing Address: | 80 Mechanic St Athol |
| State: | MA US |
| Postal Code: | 013313559 |
| Phone Number: | 9782491295 |
| Fax Number: | 9782495669 |
| NPI Enumeration Date: | 04/21/2011 |
| NPI Last Update Date: | 04/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 2353 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |