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Physicians Orthopaedic Surgery Sports Medicine

Provider NPI: 1740216811

Organization Information:
Organization is not Subpart
Authorized Official:  LYLE J MICHELI  DIRECTOR  617-355-5971

Practice Location:
319 LONGWOOD AVE  BOSTON, MA 02115-5728 US
Tel: 617-355-5971  Fax: 617-730-0178

Business Mailing Address:
P.O. BOX 3694  BOSTON, MA 02115 US
Tel: 508-946-1665  Fax: 508-947-1293

NPI Information:
NPI: 1740216811
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Orthopaedic Surgery
Sports Medicine
Emergency Medicine
N213E00000XPodiatric Medicine & Surgery Service Providers
N213ES0000XPodiatric Medicine & Surgery Service Providers
Orthopaedic Surgery

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207X00000X





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