Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 48732 - 20 | WI |
N | 111NI0900X | Internist | 48732 - 20 | WI |
Y | 207RG0100X | Gastroenterologist | 242671 | MA |
NPI | 1033292545 |
---|---|
Provider Name | Dr. Ashwin N Ananthakrishnan |
First Address | Charlestown, MA 02114 |
Second Address | Boston, MA 02114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2006 |
Last Update Date | 10/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110084764/A | (05) | MA |