Individual
EDWARD J MOSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
425 SALEM STREET, MEDFORD, MA 02155
(781) 396-8737
(617) 547-5367
Mailing address
425 SALEM ST, MEDFORD, MA 02155-3337
(781) 396-8737
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
735510
MA
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
1793
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0362263
—
MA
Enumeration date
10/11/2005
Last updated
04/24/2008
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