Healthcare Provider Details

I. General information

NPI: 1891785895
Provider Name (Legal Business Name): JAMES A STROM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 NEVINS ST STE 202
BRIGHTON MA
02135-3514
US

IV. Provider business mailing address

960 MASSACHUSETTS AVE STE 2
BOSTON MA
02118-2690
US

V. Phone/Fax

Practice location:
  • Phone: 617-779-6700
  • Fax:
Mailing address:
  • Phone: 617-414-4505
  • Fax: 617-789-2036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number40991
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: