Individual
SOHEIL S DADRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 793-6100
(508) 793-6110
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8882
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
047989
CT
207ZD0900X
Dermatopathology (Pathology) Physician
047989
CT
207ZP0101X
Anatomic Pathology Physician
047989
CT
207ZP0101X
Anatomic Pathology Physician
Primary
222785
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558403311
—
CT
Enumeration date
02/12/2007
Last updated
06/30/2023
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