Provider Demographics
NPI:1295841138
Name:GARRETT, STEVEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:GARRETT
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:MASHPEE HEALTH CENTER
Mailing Address - Street 2:5 INDUSTRIAL DRIVE, SUITE 109
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649
Mailing Address - Country:US
Mailing Address - Phone:508-539-6250
Mailing Address - Fax:508-539-6251
Practice Address - Street 1:MASHPEE HEALTH CENTER
Practice Address - Street 2:5 INDUSTRIAL DR, SUITE 109
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649
Practice Address - Country:US
Practice Address - Phone:508-539-6250
Practice Address - Fax:508-539-6251
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA202974207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA31101OtherPTAN