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General NPI Number Information
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NPI Number | 1255604906
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Entity Type | Individual
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Provider Name | AVRAAM PLOUMIS MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 02/10/2012
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 55 FRUIT ST # STR-33A MGH/ORTHO DEPT/SPINE SERVICE
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City | BOSTON
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State | MA
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Zip | 02114-2621
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Country | US
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Telephone | 617-643-3932
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Fax |
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Provider Business Mailing Address
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Address Line | 19 LINDEN ST
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City | BROOKLINE
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State | MA
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Zip | 02445-7859
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Country | US
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Telephone | 617-643-3932
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 17325
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License Number State | MN
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