Individual
SHIVDA PANDEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
732 HARRISON AVE, PRESTON, 3RD FLOOR, BOSTON, MA 02118-2371
(617) 638-7490
(617) 414-8742
Mailing address
801 ALBANY ST FL G, BOSTON, MA 02119-3791
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
268136
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110098090A
—
MA
Enumeration date
09/22/2008
Last updated
11/23/2022
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