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NPI Code Detail

MEDICARE: NANDA JAGADISH MD

MEDICARE: NANDA JAGADISH MD
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
1207L00000XAnesthesiology Physician159213MA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3050075540OTHERRR MEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1407626OTHERTUFT
2J22287OTHERMABCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144220740
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANDA JAGADISH MD
Provider Business Mailing Address
First Line : 60 EAST ST
Second Line : SUITE 1400
City : METHUEN
State : MA
Zip : 01844-4500
Country : US
Telephone Number : 978-689-4601
Fax Number : 978-689-3096
Provider Business Practice Location Address
First Line : 70 EAST ST
Second Line :
City : METHUEN
State : MA
Zip : 01844-4597
Country : US
Telephone Number : 978-687-0151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 07/08/2007

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Directions to “ NANDA JAGADISH MD” Practice Location

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