Provider Demographics
NPI:1285656314
Name:KAWAI, TATSUO (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:TATSUO
Middle Name:
Last Name:KAWAI
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGAIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-0289
Mailing Address - Fax:617-726-9322
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:WHT 510B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-9996
Practice Address - Fax:617-726-3713
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2013-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA208430204F00000X, 208600000X
VT042.0012768204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ24185OtherBCBS MA
MA0153851Medicaid
MA208430OtherTUFTS HEALTH PLAN
MA208430OtherTUFTS HEALTH PLAN
H50156Medicare UPIN