Provider Demographics
NPI:1396814414
Name:CAHAN, DAVID HARRY (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HARRY
Last Name:CAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 CENTRE ST
Mailing Address - Street 2:STE 5930
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3446
Mailing Address - Country:US
Mailing Address - Phone:617-983-7019
Mailing Address - Fax:617-983-7533
Practice Address - Street 1:1155 CENTRE ST
Practice Address - Street 2:SUITE 5985
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3432
Practice Address - Country:US
Practice Address - Phone:617-524-4431
Practice Address - Fax:617-983-7533
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38918207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA038918OtherTUFTS
MA10006OtherHARVARD-PILGRIM
MA2060507Medicaid
MA038918OtherTUFTS
A66994Medicare UPIN