Provider Demographics
NPI:1205890761
Name:PATWA, NAJMUDDIN (MD)
Entity type:Individual
Prefix:
First Name:NAJMUDDIN
Middle Name:
Last Name:PATWA
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 1:12 ALFRED STREET
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:781-756-4070
Mailing Address - Fax:781-756-4075
Practice Address - Street 1:12 ALFRED STREET
Practice Address - Street 2:SUITE 120
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:781-756-4070
Practice Address - Fax:781-756-4075
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152386207RP1001X, 207RS0012X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3186989Medicaid
MAA22069Medicare ID - Type Unspecified
MAS400215763Medicare PIN
MAF88863Medicare UPIN