MEDICARE: KANTA NAGPAUL 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	208000000X	Pediatrics Physician	208000000X	MA
2	2080P0202X	Pediatric Cardiology Physician	2080P0202X	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	035189	OTHER	MA	TUFTS
3	20376	OTHER	MA	HARVARD PILGRIM HEALTH
4	B10154401	OTHER	MA	CIGNA
5	M08394	OTHER	MA	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1780675231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KANTA NAGPAUL M.D.

Provider Business Mailing Address
First Line	:	548 LEBANON STREET
Second Line	:
City	:	MELROSE
State	:	MA
Zip	:	02176
Country	:	US
Telephone Number	:	781-665-4364
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 WOODLAND RD
Second Line	:	SUITE 205
City	:	STONEHAM
State	:	MA
Zip	:	02180-1702
Country	:	US
Telephone Number	:	781-662-2100
Fax Number	:	781-662-2284

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

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	04/10/2015

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Directions to “ KANTA NAGPAUL M.D.” Practice Location

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