Individual
NANDA JAGADISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
70 EAST ST, METHUEN, MA 01844-4597
(978) 687-0151
Mailing address
60 EAST ST, SUITE 1400, METHUEN, MA 01844-4500
(978) 689-4601
(978) 689-3096
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
159213
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0106925
—
MA
01
—
050075540
RR MEDICARE GROUP
—
05
—
30200896
—
NH
01
—
407626
TUFT
—
01
—
J22287
BCBS
MA
Enumeration date
07/26/2005
Last updated
07/08/2007
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