Provider Demographics
NPI:1962030940
Name:ANGAJALA, VARUN TEJA (MD)
Entity Type:Individual
Prefix:DR
First Name:VARUN TEJA
Middle Name:
Last Name:ANGAJALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VARUN
Other - Middle Name:
Other - Last Name:ANGAJALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:85 E CONCORD ST
Mailing Address - Street 2:GASTROENTEROLOGY, 7TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-1029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:85 E CONCORD ST
Practice Address - Street 2:GASTROENTEROLOGY, 7TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA3013919207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program