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Individual

SUBHASH C. GULATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D F A C S, INC

Contact information

Practice address
291 LINCOLN ST, SUITE 204, WORCESTER, MA 01605-3643
(508) 755-0770
(508) 753-5264
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
48512
MA
2086S0129X
Vascular Surgery Physician
48512
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110005589A
MA
Enumeration date
09/28/2006
Last updated
11/03/2020
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