Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 58095 | MA |
NPI | 1043258338 |
---|---|
Provider Name | Ram Chuttani |
First Address | Dover, MA 02030-1648 |
Second Address | Boston, MA 02215-5400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 21/06/2011 |