Provider Demographics
NPI:1508890260
Name:EHSAN, AFSHIN (MD)
Entity Type:Individual
Prefix:DR
First Name:AFSHIN
Middle Name:
Last Name:EHSAN
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 1:9 NORTHEASTERN BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-1996
Mailing Address - Country:US
Mailing Address - Phone:800-927-0002
Mailing Address - Fax:603-893-8886
Practice Address - Street 1:TUFTS NEW ENGLAND MEDICAL CENTER
Practice Address - Street 2:750 WASHINGTON ST #266
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-5594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153859208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)