Individual
KEVIN M MONAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
732 HARRISON AVE, PRESTON, 3RD FLOOR, BOSTON, MA 02118-2309
(617) 638-7490
(617) 414-8742
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
(617) 414-5405
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
74454
MA
207RC0000X
Cardiovascular Disease Physician
74454
MA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
74454
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110056702A
—
MA
Enumeration date
12/23/2005
Last updated
04/28/2014
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