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Individual

DR. VIKRAM DESHPANDE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MBBS

Contact information

Practice address
55 FRUIT STREET WRN 2, PATHOLOGY ASSOCIATES, BOSTON, MA 02114-2696
(617) 726-2967
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
209664
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2069873
MA
01
468868
TUFTS HEALTH PLAN
MA
01
J27254
BCBS MA
MA
Enumeration date
11/03/2005
Last updated
07/08/2007
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