Healthcare Provider Details

I. General information

NPI: 1699935114
Provider Name (Legal Business Name): PAVAN K BENDAPUDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MASSACHUSETTS GENERAL HOSPITAL 55 FRUIT STREET
BOSTON MA
02114
US

IV. Provider business mailing address

MASSACHUSETTS GENERAL HOSPITAL 55 FRUIT STREET
BOSTON MA
02114
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-2862
  • Fax:
Mailing address:
  • Phone: 617-726-2862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number245922
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number245922
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: