Healthcare Provider Details

I. General information

NPI: 1922205673
Provider Name (Legal Business Name): KRISTI SPAHO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PARKER HILL AVE
BOSTON MA
02120-2847
US

IV. Provider business mailing address

23 MINIHANS LN
QUINCY MA
02169-1022
US

V. Phone/Fax

Practice location:
  • Phone: 617-754-5000
  • Fax:
Mailing address:
  • Phone: 857-919-1507
  • Fax: 857-919-1507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number242738
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: