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General NPI Number Information
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NPI Number | 1639503493
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Entity Type | Individual
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Provider Name | SEAN JEFFERY ELAM AU.D.
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Gender | Male
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 75 FRANCIS STREET BRIGHAM AND WOMEN'S HOSPITAL
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City | BOSTON
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State | MA
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Zip | 02115
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Country | US
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Telephone | 617-723-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 1568 COMMONWEALTH AVE #1
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City | BOSTON
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State | MA
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Zip | 02135-5037
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Country | US
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Telephone | 309-255-0671
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1026
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License Number State | MA
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