Individual
MANISH TANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
230 HIGHLAND AVE, MEDICAL SPECIALTIES, SOMERVILLE, MA 02143-1408
(617) 665-1552
Mailing address
230 HIGHLAND AVE, MEDICAL SPECIALTIES, SOMERVILLE, MA 02143-1408
(617) 665-1552
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
155573
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0186619
—
MA
01
—
J24432
BCBS MA
MA
Enumeration date
11/20/2006
Last updated
11/15/2007
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