Individual
SANJAY R HEGDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
955 MAIN ST, SUITE 206, WINCHESTER, MA 01890-1961
(781) 729-5855
(781) 721-5891
Mailing address
955 MAIN ST STE 206, WINCHESTER, MA 01890-4302
(781) 729-5855
(781) 721-5891
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
247933
MA
207RG0100X
Gastroenterology Physician
D69588
MD
207RG0100X
Gastroenterology Physician
MT183245
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418373800
—
MD
01
—
954004-01 & 02
BLUE CROSS/BLUE SHIELD
MD
01
—
S062-0364
BLUE CROSS/BLUE SHIELD - REGIONAL
MD
Enumeration date
12/14/2006
Last updated
09/09/2016
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