Individual
VIJAY VENUGOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1611 CAMBRIDGE ST, CAMBRIDGE, MA 02138-4302
(617) 661-5500
Mailing address
1611 CAMBRIDGE ST, CAMBRIDGE, MA 02138-4302
(617) 661-5575
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
62996
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/28/2015
Last updated
02/15/2024
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