Provider Demographics
NPI:1992780084
Name:ELIAS, NAHEL (MD)
Entity type:Individual
Prefix:DR
First Name:NAHEL
Middle Name:
Last Name:ELIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-0174
Mailing Address - Fax:617-724-5993
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:WHITE 546
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-726-0174
Practice Address - Fax:617-724-5993
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA213765208600000X
VT042.0012767204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
J27707OtherBCBS MA
MA2074320Medicaid
MA469329OtherTUFTS HEALTH PLAN
I11078Medicare UPIN
MA469329OtherTUFTS HEALTH PLAN