Provider Demographics
NPI:1114940442
Name:STEPHEN, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:STEPHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:TUFTS MEDICAL CENTER DEPT OF EMERGENCY MEDICINE
Mailing Address - Street 2:750 WASHINGTON ST BOX 311
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-0311
Mailing Address - Country:US
Mailing Address - Phone:617-636-4720
Mailing Address - Fax:617-636-4723
Practice Address - Street 1:750 WASHINGTON ST # 311
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1526
Practice Address - Country:US
Practice Address - Phone:617-636-4720
Practice Address - Fax:617-636-4723
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2017-08-15
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Provider Licenses
StateLicense IDTaxonomies
MA55722207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE58860Medicare UPIN