Healthcare Provider Details

I. General information

NPI: 1497749618
Provider Name (Legal Business Name): SVEN KNUDSEN LJAAMO M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SPRINGS RD EDITH NOURSE RODGERS MEMORIAL VA HOSPITAL
BEDFORD MA
01730-1114
US

IV. Provider business mailing address

200 SPRINGS RD EDITH NOURSE RODGERS MEMORIAL VA HOSPITAL
BEDFORD MA
01730-1114
US

V. Phone/Fax

Practice location:
  • Phone: 781-687-2199
  • Fax: 781-687-2753
Mailing address:
  • Phone: 781-687-2199
  • Fax: 781-687-2753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number235193
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: