Provider Demographics
NPI:1629041462
Name:SAXENA, SHEEL (MD)
Entity Type:Individual
Prefix:
First Name:SHEEL
Middle Name:
Last Name:SAXENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:409 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-2245
Mailing Address - Country:US
Mailing Address - Phone:617-269-7500
Mailing Address - Fax:617-464-7512
Practice Address - Street 1:409 W BROADWAY
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-2245
Practice Address - Country:US
Practice Address - Phone:617-269-7500
Practice Address - Fax:617-464-7512
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA221768207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0033964OtherNEIGHBORHOOD HEALTH PLAN
MA7829699OtherCIGNA
MAJ28117OtherBLUE CROSS
MA000000028896OtherBMC HEALTHNET
MA467561OtherTUFTS HEALTH PLAN
MAAA18472OtherHARVARD PILGRIM
MA467561OtherSECURE HORIZONS
MA467561OtherSECURE HORIZONS
MAJ28117OtherBLUE CROSS