Provider Demographics
NPI:1043573314
Name:SINHA, MICHAEL SUJAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SUJAN
Last Name:SINHA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:720 HARRISON AVE FL 5
Mailing Address - Street 2:BMC DEPARTMENT OF GRADUATE MEDICAL EDUCATION
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2371
Mailing Address - Country:US
Mailing Address - Phone:617-414-5423
Mailing Address - Fax:617-638-6744
Practice Address - Street 1:720 HARRISON AVE FL 5
Practice Address - Street 2:BMC DEPARTMENT OF GRADUATE MEDICAL EDUCATION
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2371
Practice Address - Country:US
Practice Address - Phone:617-414-5423
Practice Address - Fax:617-638-6744
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program