Provider Demographics
NPI:1417305400
Name:MESFIN, NATHAN MEBRAHTU (MD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:MEBRAHTU
Last Name:MESFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 E CONCORD ST # R304
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2642
Mailing Address - Country:US
Mailing Address - Phone:617-358-2800
Mailing Address - Fax:
Practice Address - Street 1:72 E CONCORD ST # R304
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2642
Practice Address - Country:US
Practice Address - Phone:617-358-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA279103207RC0200X, 207RP1001X
IL125068665207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine