Organization
MINIMALLY INVASTIVE THORACIC SURGERY ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRODYUT K PODDAR M.D. (PRESIDENT)
(781) 932-6487
Entity
Organization
Contact information
Practice address
800 W CUMMINGS PARK, STE. 4700, WOBURN, MA 01801-6372
(781) 932-6487
(781) 932-6486
Mailing address
340 MAIN ST, STE. 670, WORCESTER, MA 01608-1604
(508) 754-3566
(508) 438-6368
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110083476A
—
MA
Enumeration date
04/07/2010
Last updated
12/06/2011
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