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Individual
S. TED TREVES
Active
Individual
S. TED TREVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
34066
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034066
TUFTS HEALTH CARE
MA
05
—
2045494
—
MA
01
—
J22249
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/27/2005
Last updated
02/24/2011
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