Healthcare Provider Details

I. General information

NPI: 1780674085
Provider Name (Legal Business Name): JAMES A STROM MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE ST
BOSTON MA
02135-2907
US

IV. Provider business mailing address

460 TOTTEN POND RD
WALTHAM MA
02451-1991
US

V. Phone/Fax

Practice location:
  • Phone: 617-783-3995
  • Fax: 617-789-2036
Mailing address:
  • Phone: 781-890-9933
  • Fax: 781-890-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES STROM
Title or Position: PRESIDENT
Credential: MD
Phone: 617-783-3995