MEDICARE: DIDEM INANOGLU 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	208100000X	Physical Medicine & Rehabilitation Physician	L6955	TX
2	208100000X	Physical Medicine & Rehabilitation Physician	289964	MA

General Provider Information

NPI Number	:	1255324422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIDEM INANOGLU M.D.

Provider Business Mailing Address
First Line	:	55 FRUIT ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02114-2696
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 WARREN ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02135-3602
Country	:	US
Telephone Number	:	617-254-3800
Fax Number	:

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	10/25/2023

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Directions to “ DIDEM INANOGLU M.D.” Practice Location

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