Healthcare Provider Details

I. General information

NPI: 1033222195
Provider Name (Legal Business Name): AMADO ALEJANDRO BAEZ MD, MSC, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST DEPT OF EMERGENCY MEDICINE
BOSTON MA
02115-6110
US

IV. Provider business mailing address

75 FRANCIS ST DEPT OF EMERGENCY MEDICINE
BOSTON MA
02115-6110
US

V. Phone/Fax

Practice location:
  • Phone: 617-525-8466
  • Fax: 617-732-6336
Mailing address:
  • Phone: 617-525-8466
  • Fax: 617-732-6336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number226538
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: