Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 245710 | MA |
NPI | 1043479587 |
---|---|
Provider Name | Vilas R Patwardhan |
First Address | Boston, MA 02215 |
Second Address | Boston, MA 02215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2008 |
Last Update Date | 04/03/2016 |