Provider Demographics
NPI:1053379008
Name:MAAN, MOHENDER S (MD)
Entity type:Individual
Prefix:
First Name:MOHENDER
Middle Name:S
Last Name:MAAN
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 1:14N HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-3416
Mailing Address - Country:US
Mailing Address - Phone:716-238-0747
Mailing Address - Fax:781-872-1294
Practice Address - Street 1:585 LEBANON ST
Practice Address - Street 2:MELROSE WAKEFIELD HOSPITAL
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3225
Practice Address - Country:US
Practice Address - Phone:781-979-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227477207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine