Individual
DR. JOEL KEVIN RAJ SAMUEL GNANAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS, MD
Contact information
Practice address
55 FRUIT ST RM 197, BOSTON, MA 02114-2696
(617) 724-5246
Mailing address
55 FRUIT ST, BLK SB RM 0029A, BOSTON, MA 02114
(617) 724-5246
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1023727
MA
Other
Enumeration date
09/18/2023
Last updated
11/04/2025
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