Provider Demographics
NPI:1972753838
Name:THAMARAICHELVAN, UMARANI (MD)
Entity Type:Individual
Prefix:
First Name:UMARANI
Middle Name:
Last Name:THAMARAICHELVAN
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 1:65 LAKE AVE
Mailing Address - Street 2:#827
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1199
Mailing Address - Country:US
Mailing Address - Phone:508-853-1074
Mailing Address - Fax:
Practice Address - Street 1:SALTER SCHOOL
Practice Address - Street 2:184 WEST BOYLSTON
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:01583
Practice Address - Country:US
Practice Address - Phone:508-853-1074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233620207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine