Basic Information
| Provider Information | |||||||||
| NPI: | 1215345269 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHRESTHA | ||||||||
| FirstName: | MAHESH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 673 FRANKLIN ST | ||||||||
| Address2: | APT 201 A | ||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016041847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8572345474 | ||||||||
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| Practice Location | |||||||||
| Address1: | 123 SUMMER ST | ||||||||
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| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016081216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083636208 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2014 | ||||||||
| LastUpdateDate: | 04/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 259802 | MA | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 259802 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.