Individual
DR. DIVAKAR MANDAPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF SURGERY/CARDIOTHORACIC, WORCESTER, MA 01655-0002
(508) 334-3278
(508) 334-7284
Mailing address
PO BOX 415348, BOSTON, MA 02241-0001
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
216636
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2096790
—
MA
Enumeration date
06/10/2006
Last updated
02/20/2023
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