Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 234702 | MA |
Y | 207VE0102X | Reproductive Endocrinologist | 234702 | MA |
NPI | 1295046654 |
---|---|
Provider Name | Dr. Shruthi Mahalingaiah |
First Address | Boston, MA 02118 |
Second Address | Boston, MA 02118-4001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2010 |
Last Update Date | 26/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1295046654 | (05) | MA |