Healthcare Provider Details

I. General information

NPI: 1164124327
Provider Name (Legal Business Name): ELEANOR CALDWELL SEMMES MD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE CB1110, HOUSESTAFF LOUNGE
BOSTON MA
02115
US

IV. Provider business mailing address

300 LONGWOOD AVE CB1110, HOUSESTAFF LOUNGE
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-8241
  • Fax:
Mailing address:
  • Phone: 617-355-8241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number1027081
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: