Provider Demographics
NPI:1144267832
Name:AJEENA, ABDUL-WAHID K (MD)
Entity type:Individual
Prefix:
First Name:ABDUL-WAHID
Middle Name:K
Last Name:AJEENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:130 THOREAU RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2493
Mailing Address - Country:US
Mailing Address - Phone:978-372-2728
Mailing Address - Fax:
Practice Address - Street 1:61 BROWN STREET
Practice Address - Street 2:PENTUCKET ORTHOPAEDICS & SPORT MEDICINE
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-372-2728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA77242207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery