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General NPI Number Information
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NPI Number | 1124002167
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Entity Type | Individual
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Provider Name | JAMES ARTHUR STREET M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 133 OLD ROAD TO 9 ACRE COR EMERSON HOSPITAL
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City | CONCORD
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State | MA
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Zip | 01742-4159
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Country | US
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Telephone | 978-287-3162
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Fax | 978-287-3508
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Provider Business Mailing Address
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Address Line | 18 WINTERBERRY WAY
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City | BEDFORD
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State | MA
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Zip | 01730-1574
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Country | US
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Telephone | 781-275-5997
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 71834
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME 63244
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License Number State | FL
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