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NPI Code Detail

MEDICARE: DR. STEPHEN LOUIS BOSWELL M.D.

MEDICARE: DR. STEPHEN LOUIS BOSWELL 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
1207R00000XInternal Medicine Physician56428MA

General Provider Information

NPI Number : 1477541217
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN LOUIS BOSWELL M.D.
Provider Business Mailing Address
First Line : 193 W BROOKLINE ST
Second Line :
City : BOSTON
State : MA
Zip : 02118-1279
Country : US
Telephone Number : 617-927-6171
Fax Number : 617-425-5714
Provider Business Practice Location Address
First Line : 1340 BOYLSTON ST
Second Line :
City : BOSTON
State : MA
Zip : 02215-4302
Country : US
Telephone Number : 617-927-6171
Fax Number : 617-425-5714
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2005
Last Update Date : 01/26/2012

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