Provider Demographics
NPI:1700986122
Name:HARTUNIAN, BYRON VARTAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:VARTAN
Last Name:HARTUNIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:777 CONCORD AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1056
Mailing Address - Country:US
Mailing Address - Phone:617-864-5700
Mailing Address - Fax:617-864-0883
Practice Address - Street 1:777 CONCORD AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1056
Practice Address - Country:US
Practice Address - Phone:617-864-5700
Practice Address - Fax:617-864-0883
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA40158174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9727302Medicaid
MAB31105OtherHMO BLUE
MA17557OtherHARVARD PILGRIM
MA040148OtherTUFTS
MA17557OtherHARVARD PILGRIM
MA9727302Medicaid