Provider Demographics
NPI:1821188830
Name:VESEL, TAMARA (MD)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:
Last Name:VESEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BINNEY ST
Mailing Address - Street 2:DFCI 3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-632-5042
Mailing Address - Fax:617-632-3161
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:DANA FARBER CANCER INSTITUTE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-632-5042
Practice Address - Fax:617-632-3161
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1518792080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3158985OtherMASS HEALTH MA MEDICAID
AA10643OtherHPHC DFCI ONLY
151879OtherTUFTS
5156075OtherCIGNA
MAJ16849OtherBCBS OF MASSACHUSETTS
5156075OtherCIGNA
F85286Medicare UPIN