Individual
SOUMYA GANAPATHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-3017
(781) 744-8000
Mailing address
200 UNICORN PARK DR STE 401, WOBURN, MA 01801-3342
(781) 756-6760
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
238614
MA
207P00000X
Emergency Medicine Physician
D61187
MD
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
238614
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404767200
—
MD
Enumeration date
09/14/2006
Last updated
04/27/2023
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