MEDICARE: DR. NIKHEEL SHRINIVAS KOLATKAR M.D.

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	219119	MA

General Provider Information

NPI Number	:	1396748463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIKHEEL SHRINIVAS KOLATKAR M.D.

Provider Business Mailing Address
First Line	:	121 COMMONWEALTH AVE
Second Line	:	APT 6
City	:	BOSTON
State	:	MA
Zip	:	02116-2336
Country	:	US
Telephone Number	:	617-304-9599
Fax Number	:	888-406-7390

Provider Business Practice Location Address
First Line	:	221 LONGWOOD AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-5804
Country	:	US
Telephone Number	:	617-732-7947
Fax Number	:	617-732-5764

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/08/2007

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