Healthcare Provider Details

I. General information

NPI: 1174510226
Provider Name (Legal Business Name): GEORGE M FLESH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 INDEPENDENCE DR
CHESTNUT HILL MA
02467-3628
US

IV. Provider business mailing address

291 INDEPENDENCE DR
CHESTNUT HILL MA
02467-3628
US

V. Phone/Fax

Practice location:
  • Phone: 617-541-6646
  • Fax: 617-541-7548
Mailing address:
  • Phone: 617-541-6646
  • Fax: 617-541-7548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number159737
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: