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NPI Code Detail

MEDICARE: DR. MEGAN R MISTRY DO

MEDICARE:  DR. MEGAN R MISTRY  DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician205325MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1J23060OTHERBLUE CROSS

General Provider Information

NPI Number : 1053327791
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MEGAN R MISTRY DO
Provider Business Mailing Address
First Line : 1450 HIGHLAND AVE
Second Line :
City : NEEDHAM
State : MA
Zip : 02492-2690
Country : US
Telephone Number : 781-449-0020
Fax Number : 781-449-3181
Provider Business Practice Location Address
First Line : 1450 HIGHLAND AVE
Second Line :
City : NEEDHAM
State : MA
Zip : 02492-2690
Country : US
Telephone Number : 781-449-0020
Fax Number : 781-449-3181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 03/26/2013

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