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Individual

DR. ANU RADHA PATHAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
85 SOUTH ST, SOUTHBRIDGE, MA 01550-4005
(508) 765-2700
(508) 764-2563
Mailing address
85 SOUTH ST, SOUTHBRIDGE, MA 01550-4005
(508) 765-2700
(508) 764-2563

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
154034
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3195074
MA
Enumeration date
11/23/2005
Last updated
01/17/2012
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