Provider Demographics
NPI:1245483965
Name:AL-QUTHAMI, ADEEB H (MD)
Entity type:Individual
Prefix:DR
First Name:ADEEB
Middle Name:H
Last Name:AL-QUTHAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT. OF MEDICINE MEDICAL SERVICE GROUP
Mailing Address - Street 2:90 PRESIDENTIAL PLAZA, SUITE 5010
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202
Mailing Address - Country:US
Mailing Address - Phone:315-464-9335
Mailing Address - Fax:
Practice Address - Street 1:30 RESNIK RD LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7211
Practice Address - Country:US
Practice Address - Phone:508-746-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338450207RC0000X
MA253841207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease