Individual
DR. SUSAN V KATTAPURAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, RADIOLOGICAL ASSOCIATES YAW 6, BOSTON, MA 02114-2696
(617) 726-8305
(617) 726-5282
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-8305
(617) 726-5282
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
43365
MA
2085R0202X
Diagnostic Radiology Physician
Primary
43365
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2084171
—
MA
01
—
709682
TUFTS HEALTH PLAN
MA
01
—
C05213
BCBS MA
MA
Enumeration date
10/27/2005
Last updated
08/02/2012
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