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NPI 1295855658

NPI 1295855658 : JULIANNE STOUGHTON MD PC : STONEHAM, MA

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General NPI Number Information
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    NPI Number           |    1295855658
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    Entity Type          |    Organization 
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    Legal Business Name  |    JULIANNE STOUGHTON MD PC 
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Dates
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    Enumeration Date     |    03/30/2007
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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                  |    02180-3647
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    Country              |    US
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    Telephone            |    781-438-8117
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    Fax                  |    
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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                  |    02180-3647
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    Country              |    US
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    Telephone            |    781-438-8117
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     JULIANNE  STOUGHTON 
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    Credential           |    MD
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    Telephone            |    781-438-8117
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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       |    
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    License Number State |    
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