Basic Information
| Provider Information | |||||||||
| NPI: | 1043479587 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATWARDHAN | ||||||||
| FirstName: | VILAS | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 FRANCIS ST, SUITE 8E | ||||||||
| Address2: | BETH ISRAEL DEACONESS MEDICAL CENTER | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176321070 | ||||||||
| FaxNumber: | 6176321065 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 FRANCIS ST, SUITE 8E | ||||||||
| Address2: | BETH ISRAEL DEACONESS MEDICAL CENTER | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176321070 | ||||||||
| FaxNumber: | 6176321065 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2008 | ||||||||
| LastUpdateDate: | 03/04/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 245710 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.