Individual
SHASHIDHARA NANJUNDASWAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 SUMMER ST, SUITE 230S, WORCESTER, MA 01608-1216
(508) 368-3150
(508) 368-3152
Mailing address
630 PLANTATION ST, WOT 12TH FL, WORCESTER, MA 01605-2038
(508) 368-5532
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
225327
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2115646
—
MA
Enumeration date
02/09/2006
Last updated
04/10/2014
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