Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 256400 | MA |
NPI | 1003083270 |
---|---|
Provider Name | Dr. Mitesh Mahesh Kabadi |
First Address | Quincy, MA 02169-0909 |
Second Address | Quincy, MA 02169-0909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 19/02/2015 |