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NPI Code Detail

MEDICARE: SCOTT J CULLEN M.D.

MEDICARE:   SCOTT J CULLEN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician153543MA

General Provider Information

NPI Number : 1184671810
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT J CULLEN M.D.
Provider Business Mailing Address
First Line : 57 WINSLOW AVE
Second Line :
City : SOMERVILLE
State : MA
Zip : 02144-2502
Country : US
Telephone Number : 617-454-8469
Fax Number :
Provider Business Practice Location Address
First Line : 100 WILLIAM ST
Second Line :
City : WELLESLEY HILLS
State : MA
Zip : 02481-3701
Country : US
Telephone Number : 617-454-8469
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 07/08/2007

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Directions to “ SCOTT J CULLEN M.D.” Practice Location

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