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NPI Code Detail

MEDICARE: DR. SHRUTI HEGDE M.D

MEDICARE: DR. SHRUTI HEGDE 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
1207RC0000XCardiovascular Disease Physician1018453MA
2207R00000XInternal Medicine Physician260337MA
3207RC0000XCardiovascular Disease Physician036-153236IL
4207UN0901XNuclear Cardiology Physician1018453MA

General Provider Information

NPI Number : 1295143725
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHRUTI HEGDE M.D
Provider Business Mailing Address
First Line : PO BOX 415348
Second Line :
City : BOSTON
State : MA
Zip : 02241-5348
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 55 LAKE AVE N
Second Line :
City : WORCESTER
State : MA
Zip : 01655-0002
Country : US
Telephone Number : 508-334-3452
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2014
Last Update Date : 07/01/2025

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