Individual
DR. VANDANA LAXMI MADHAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
175 CAMBRIDGE ST, CPZS-546, MASSGENERAL HOSPITAL FOR CHILDREN, BOSTON, MA 02114-2743
(617) 643-0722
(617) 643-0395
Mailing address
175 CAMBRIDGE ST, CPZS-546, MASSGENERAL HOSPITAL FOR CHILDREN, BOSTON, MA 02114-2743
(617) 643-0722
(617) 643-0395
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
223881
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2103214
—
MA
01
—
468282
TUFTS HEALTH PLAN
MA
01
—
J28679
BCBS MA
MA
Enumeration date
02/17/2006
Last updated
04/12/2013
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