Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L-251738 | MA |
N | 111NI0900X | Internist | L-251738 | MA |
Y | 207RC0000X | Internist - Cardiovascular Disease | 262691 | MA |
NPI | 1023370467 |
---|---|
Provider Name | Muthiah Vaduganathan |
First Address | Brookline, MA 02445-6007 |
Second Address | Boston, MA 02114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2012 |
Last Update Date | 23/07/2019 |