Provider Demographics
NPI:1790892834
Name:TRAN, TAI M (MD)
Entity Type:Individual
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First Name:TAI
Middle Name:M
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:175 BEACON ST
Mailing Address - Street 2:APT. #301
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3638
Mailing Address - Country:US
Mailing Address - Phone:781-744-8170
Mailing Address - Fax:
Practice Address - Street 1:LAHEY MEDICAL CTR
Practice Address - Street 2:41 MALL ROAD
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2012-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2299792085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology