Individual
DR. ARA KETCHEDJIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
850 HARRISON AVE, YACC BN-C7, BOSTON, MA 02118-4001
(617) 414-5405
(617) 414-6031
Mailing address
850 HARRISON AVE, YACC BN-C7, BOSTON, MA 02118-4001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
219989
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
219989
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110075849A
—
MA
Enumeration date
01/30/2007
Last updated
11/07/2013
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