# CHMC SURGICAL FOUNDATION INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902977515
- **Authorized official:** DR. STEVEN J FISHMAN MD (CHIEF OF SURGERY)
- **Authorized official phone:** (617) 355-6000

## Contact information

- **Practice address:** 300 LONGWOOD AVE, FEGAN 3, BOSTON, MA 02115-5724
- **Practice address phone:** (617) 355-8326
- **Practice address fax:** (617) 730-0475
- **Mailing address:** 300 LONGWOOD AVE, BOSTON, MA 02115-5724
- **Mailing address phone:** (617) 355-8326
- **Mailing address fax:** (617) 730-0475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | — | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 10/16/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 42767602 | — | ME |
| 05 | — | 9725059 | — | MA |