Healthcare Provider Details

I. General information

NPI: 1801277173
Provider Name (Legal Business Name): JOSE J. ACEVEDO MEJIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSE JULIAN ACEVEDO

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 HARRISON AVENUE, 3RD FL MOAKLEY BLDG
BOSTON MA
02118
US

IV. Provider business mailing address

960 MASSACHUSETTS AVE FL 2
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-6428
  • Fax: 617-638-5756
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number286363
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number286363
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number286363
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: