Individual
DR. JAYANT GOPAL PHADKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 SUMMER ST, STE 695, WORCESTER, MA 01608-1216
(508) 363-5630
(508) 363-5630
Mailing address
123 SUMMER ST, STE 695, WORCESTER, MA 01608-1216
(508) 363-5630
(508) 363-5630
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
078071
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3111083
—
MA
Enumeration date
12/06/2005
Last updated
05/14/2012
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