Individual
DR. DEEPAK SHAM TANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 PARKER HILL, BOSTON, MA 02120
(617) 731-0016
(617) 739-6866
Mailing address
125 PARKER HILL, BOSTON, MA 02120
(617) 731-0016
(617) 739-6866
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
46565
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11151
HPHC
MA
01
—
706450
TUFTS
MA
01
—
92688
AETNA
MA
01
—
M14268
BCBS
MA
01
—
VC6000170977
COMMONWEALTH OF MA
MA
Enumeration date
10/23/2006
Last updated
07/08/2007
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