Organization
DAVID MENON CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MENON MD (PRESIDENT/OWNER)
(617) 625-9992
Entity
Organization
Contact information
Practice address
33 BOW ST, SOMERVILLE, MA 02143-2937
(617) 625-9992
Mailing address
PO BOX 201, SOMERVILLE, MA 02143-0004
(617) 625-9992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
694457
TUFTS
MA
05
—
9716599
—
MA
01
—
M18125
BCBS
MA
Enumeration date
07/28/2006
Last updated
10/10/2007
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