MEDICARE: BENJAMIN L JAMIESON MS, LAT

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1750817508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN L JAMIESON MS, LAT

Provider Business Mailing Address
First Line	:	31 WALDECK ST
Second Line	:
City	:	DORCHESTER CENTER
State	:	MA
Zip	:	02124-2115
Country	:	US
Telephone Number	:	978-605-6900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 POND PARK RD
Second Line	:
City	:	HINGHAM
State	:	MA
Zip	:	02043-4347
Country	:	US
Telephone Number	:	781-337-5555
Fax Number	:

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	03/16/2023

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