MEDICARE: JEFFREY POPMA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	157915	MA
2	207RI0011X	Interventional Cardiology Physician	157915	MA

General Provider Information

NPI Number	:	1033176466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY POPMA M.D.

Provider Business Mailing Address
First Line	:	185 PILGRIM RD
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-5324
Country	:	US
Telephone Number	:	617-632-9214
Fax Number	:	617-632-7460

Provider Business Practice Location Address
First Line	:	185 PILGRIM RD # BAKER4
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-5324
Country	:	US
Telephone Number	:	617-632-9210
Fax Number	:	617-632-7460

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	02/01/2016

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