Provider Demographics
NPI:1225010440
Name:JURIST, LOUIS M (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:M
Last Name:JURIST
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:460 TOTTEN POND RD
Mailing Address - Street 2:C/O MZI
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1906
Mailing Address - Country:US
Mailing Address - Phone:781-890-9933
Mailing Address - Fax:781-890-9950
Practice Address - Street 1:761 WORCESTER RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5224
Practice Address - Country:US
Practice Address - Phone:508-872-7881
Practice Address - Fax:508-872-9545
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA50736207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA17459OtherHPHC
MA2097222Medicaid
MAJ01045OtherBCBS
MA050736OtherTUFTS
A53571Medicare UPIN
MA17459OtherHPHC