Individual
DR. SHANMUGHA VIGNESHWAR PADMANABHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5491
(617) 632-9880
Mailing address
171 PILGRIM RD, BOSTON, MA 02215-5332
(617) 632-9880
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1015104
MA
207R00000X
Internal Medicine Physician
125074740
IL
207RN0300X
Nephrology Physician
Primary
1015104
MA
390200000X
Student in an Organized Health Care Education/Training Program
125074740
IL
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
07/25/2019
Last updated
06/30/2026
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