Individual
DR. DHIRENDRA SINGH BANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1153 CENTRE ST, SUITE 5935 FAULKNER HOSPITAL, JAMAICA PLAIN, MA 02130-3446
(617) 524-3700
(617) 524-5839
Mailing address
19 ALHAMBRA RD, WEST ROXBURY, MA 02132-1815
(617) 325-9080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
035706
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035706
TUFTS
MA
05
—
2002779
—
MA
01
—
6389
HARVARD PILGRIM
MA
01
—
M17628
BLUECROSS BLUESHIELD
MA
Enumeration date
04/18/2006
Last updated
08/27/2010
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