MEDICARE: DR. SHANTANU G BASU 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
1	208600000X	Surgery Physician	44318	MA

General Provider Information

NPI Number	:	1326129271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANTANU G BASU MD

Provider Business Mailing Address
First Line	:	150 CONCORD RD
Second Line	:
City	:	WESTON
State	:	MA
Zip	:	02493-1340
Country	:	US
Telephone Number	:	617-447-5467
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 CONCORD RD
Second Line	:
City	:	WESTON
State	:	MA
Zip	:	02493-1340
Country	:	US
Telephone Number	:	617-447-5467
Fax Number	:

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	05/24/2026

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