Provider Demographics
NPI:1750525291
Name:BABU, SUMA (MBBS, MPH)
Entity type:Individual
Prefix:DR
First Name:SUMA
Middle Name:
Last Name:BABU
Suffix:
Gender:F
Credentials:MBBS, MPH
Other - Prefix:DR
Other - First Name:SUMA
Other - Middle Name:
Other - Last Name:B
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS, MPH
Mailing Address - Street 1:165 CAMBRIDGE ST STE 668
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2783
Mailing Address - Country:US
Mailing Address - Phone:617-724-3914
Mailing Address - Fax:617-724-7290
Practice Address - Street 1:165 CAMBRIDGE ST STE 668
Practice Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2783
Practice Address - Country:US
Practice Address - Phone:617-724-3914
Practice Address - Fax:617-724-7290
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2625332084N0400X, 2084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine