Individual
DR. SHAHIN TABATABAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 PARKMAN ST, DEPT OF UROLOGY MGH, BOSTON, MA 02114-3117
(617) 726-3010
(617) 726-6131
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-3574
(617) 726-6131
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
209109
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0188760
—
MA
01
—
209109
TUFTS HEALTH PLAN
MA
01
—
J25678
BCBS MA
MA
Enumeration date
11/03/2005
Last updated
11/26/2012
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