Healthcare Provider Details

I. General information

NPI: 1730170366
Provider Name (Legal Business Name): JOHN ROBINSON SALTZMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST ENDOSCOPY CENTER GASTROENTEROLOGY DIVISION
BOSTON MA
02115
US

IV. Provider business mailing address

75 FRANCIS ST
BOSTON MA
02115-6110
US

V. Phone/Fax

Practice location:
  • Phone: 617-525-8763
  • Fax: 617-264-5264
Mailing address:
  • Phone: 617-525-8763
  • Fax: 617-732-6389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number71725
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: