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NPI 1659352904

NPI 1659352904 : JAMES H THRALL MD : BOSTON, MA

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General NPI Number Information
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    NPI Number           |    1659352904
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES H THRALL MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/11/2005
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    Last Update Date     |    01/03/2013
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Provider Practice Location Address
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    Address Line         |    55 FRUIT STREET FND 2 RAIOLOGICAL ASSOCIATES
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    City                 |    BOSTON
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    State                |    MA
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    Zip                  |    02114-2696
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    Country              |    US
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    Telephone            |    617-726-5244
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    Fax                  |    617-726-3077
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Provider Business Mailing Address
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    Address Line         |    PO BOX 9142 MASS GENERAL PHYSICIAN ORGANIZATION
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    City                 |    CHARLESTOWN
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    State                |    MA
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    Zip                  |    02129-9142
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    Country              |    US
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    Telephone            |    617-726-5244
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    Fax                  |    617-726-3077
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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        |    207U00000X
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    Taxonomy Name        |    Nuclear Medicine Physician
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    License Number       |    58918
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    License Number State |    MA
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Taxonomy #2
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    Taxonomy Code        |    2085N0904X
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    Taxonomy Name        |    Nuclear Radiology Physician
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    License Number       |    58918
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    License Number State |    MA
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