Provider Demographics
NPI:1992737423
Name:KATWA, UMAKANTH A (MD)
Entity type:Individual
Prefix:DR
First Name:UMAKANTH
Middle Name:A
Last Name:KATWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:UMAKANTH
Other - Middle Name:A
Other - Last Name:KHATWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 INTERVALE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3707
Mailing Address - Country:US
Mailing Address - Phone:508-361-8359
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE, DEPARTMENT OF RESPIRATORY DISEASES
Practice Address - Street 2:BOSTON CHILDREN'S HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2283652080P0214X, 2080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology