Individual
SERVET TATLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-8080
Mailing address
75 FRANCIS ST, RADIOLOGY BRIGHAM WOMENS HOSPITAL, BOSTON, MA 02115-6110
(617) 732-6304
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
220363
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD458182
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103130997
—
PA
05
—
2067129
—
MA
01
—
46232
TUFTS HEALTH CARE
MA
01
—
J27615
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/13/2005
Last updated
11/29/2018
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