Individual
BHAWNA AWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 GOVERNORS AVE, MEDFORD, MA 02155-1644
(781) 391-5400
Mailing address
812 MEMORIAL DR, APT 1614, CAMBRIDGE, MA 02139-4638
(917) 379-9258
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18890
MA
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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