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General NPI Number Information
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NPI Number | 1922046721
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Entity Type | Individual
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Provider Name | DANA C MISKULIN MD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 800 WASHINGTON ST BOX 391
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City | BOSTON
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State | MA
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Zip | 02111-1552
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Country | US
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Telephone | 617-636-5866
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Fax |
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Provider Business Mailing Address
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Address Line | 11 CHAPEL ST
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City | SOMERVILLE
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State | MA
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Zip | 02144-1901
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Country | US
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Telephone | 617-628-0910
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 213820
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License Number State | MA
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