Individual
DR. RICHARD LAWRENCE KRADIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, COX 2, BOSTON, MA 02114-2696
(617) 726-1721
(617) 726-2365
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 726-1721
(617) 726-2365
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
44014
MA
207RP1001X
Pulmonary Disease Physician
Primary
44014
MA
207ZP0101X
Anatomic Pathology Physician
44014
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0116432
—
MA
01
—
044014
TUFTS HEALTH PLAN
MA
01
—
C05276
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
02/11/2014
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