Individual
DR. CHAITANYA MUDGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, YAW 2100, BOSTON, MA 02114-2621
(617) 726-5100
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-4700
(617) 724-8532
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
153170
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2086492
—
MA
01
—
750226
TUFTS HEALTH PLAN
MA
01
—
J22899
BCBS MA
MA
Enumeration date
11/09/2005
Last updated
08/31/2012
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