# S. TED TREVES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1689651150
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085N0904X | Nuclear Radiology Physician | 34066 | MA | Yes |

## Other

- **Enumeration date:** 12/27/2005
- **Last updated:** 02/24/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 034066 | TUFTS HEALTH CARE | MA |
| 05 | — | 2045494 | — | MA |
| 01 | — | J22249 | BLUE CROSS BLUE SHIELD | MA |