Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 232912 | MA |
N | 111NI0900X | Internist | 232912 | MA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 232912 | MA |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | A127397 | CA |
NPI | 1043400187 |
---|---|
Provider Name | Thomas M Tadros |
First Address | Brookline, MA 02445-6007 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 23/11/2018 |