Healthcare Provider Details

I. General information

NPI: 1154310381
Provider Name (Legal Business Name): GEORGE SINCLAIR DYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST, DEPT OF ORTHOPEDIC SURGERY BIGHAM AND WOMEN'S HOSPITAL
BOSTON MA
02115
US

IV. Provider business mailing address

375 BOYLSTON ST
BROOKLINE MA
02445-6007
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-6607
  • Fax: 617-730-2815
Mailing address:
  • Phone: 185-730-7086
  • Fax: 857-307-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number227094
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number227094
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: