Provider Demographics
NPI:1649431107
Name:JEFFREY M DARROW MD, PC
Entity type:Organization
Organization Name:JEFFREY M DARROW MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MCMILLAN
Authorized Official - Last Name:DARROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-267-0710
Mailing Address - Street 1:170 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2704
Mailing Address - Country:US
Mailing Address - Phone:617-267-0710
Mailing Address - Fax:617-236-8704
Practice Address - Street 1:170 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2704
Practice Address - Country:US
Practice Address - Phone:617-267-0710
Practice Address - Fax:617-236-8704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55656208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM17153OtherBLUE CROSS BLUE SHIELD