Healthcare Provider Details

I. General information

NPI: 1528025996
Provider Name (Legal Business Name): SCOTT DAVID SOLOMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST PBB1 BRIGHAM AND WOMENS HOSPITAL CARDIOVASCULAR DIVISION
BOSTON MA
02115
US

IV. Provider business mailing address

375 BOYLSTON ST
BROOKLINE MA
02445-6007
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-7182
  • Fax:
Mailing address:
  • Phone: 857-307-0896
  • Fax: 857-307-0899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number60372
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: