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General NPI Number Information
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NPI Number | 1033191671
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Entity Type | Individual
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Provider Name | JULIANNE STOUGHTON MD
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Gender | Female
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 92 MONTVALE AVE SUITE 3200
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City | STONEHAM
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State | MA
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Zip | 02180-3660
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Country | US
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Telephone | 781-438-8117
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Fax | 781-438-8116
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Provider Business Mailing Address
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Address Line | 92 MONTVALE AVE SUITE 3200
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City | STONEHAM
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State | MA
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Zip | 02180-3660
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Country | US
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Telephone | 781-438-8117
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Fax | 781-438-8116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 79594
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 79594
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License Number State | MA
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