Provider Demographics
NPI:1134359342
Name:HARIHARAN, PRAVEEN (MD MPH)
Entity type:Individual
Prefix:DR
First Name:PRAVEEN
Middle Name:
Last Name:HARIHARAN
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 HAYDEN ROWE ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-2805
Mailing Address - Country:US
Mailing Address - Phone:857-274-4716
Mailing Address - Fax:833-944-2018
Practice Address - Street 1:223 WALNUT ST STE 20
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7500
Practice Address - Country:US
Practice Address - Phone:857-274-4716
Practice Address - Fax:617-420-4726
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250635207P00000X, 207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110162779BMedicaid