Healthcare Provider Details

I. General information

NPI: 1760689616
Provider Name (Legal Business Name): RALPH METSON, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

0 EMERSON PL SUITE 2D
BOSTON MA
02114-2241
US

IV. Provider business mailing address

0 EMERSON PL SUITE 2D
BOSTON MA
02114-2241
US

V. Phone/Fax

Practice location:
  • Phone: 617-227-4366
  • Fax: 617-227-4482
Mailing address:
  • Phone: 617-227-4366
  • Fax: 617-227-4482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number54878
License Number StateMA

VIII. Authorized Official

Name: RALPH BELL METSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 617-227-4366