Individual
DR. HASAN BAZARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, RENAL ASSOCIATES GRB 1003, BOSTON, MA 02114-2621
(617) 726-5050
(617) 724-1122
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-5050
(617) 724-1122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
54327
MA
207RN0300X
Nephrology Physician
Primary
54327
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3047300
—
MA
01
—
705721
TUFTS HEALTH PLAN
MA
01
—
J08154
BCBS MA
MA
Enumeration date
11/07/2005
Last updated
11/21/2012
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