Provider Demographics
NPI:1063461572
Name:MUPPANA, SARASWATHI DEVI V (MD)
Entity Type:Individual
Prefix:
First Name:SARASWATHI DEVI
Middle Name:V
Last Name:MUPPANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HIGHLAND ST
Mailing Address - Street 2:STE 103
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3801
Mailing Address - Country:US
Mailing Address - Phone:617-696-9600
Mailing Address - Fax:617-969-4308
Practice Address - Street 1:100 HIGHLAND ST
Practice Address - Street 2:STE 103
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3801
Practice Address - Country:US
Practice Address - Phone:617-696-9600
Practice Address - Fax:617-690-3048
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242209207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA70010000J48324OtherBCBS
MA110088384AMedicaid
MA70010000J48324OtherBCBS