Individual
DR. LEWIS BALL HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST YAW 4, PEDIATRIC MEDICINE, BOSTON, MA 02114-2696
(617) 724-3358
(617) 724-1911
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
1206
MA
208000000X
Pediatrics Physician
28697
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2022745
—
MA
01
—
724452
TUFTS HEALTH PLAN
MA
01
—
M07471
BCBS MA
MA
Enumeration date
02/14/2006
Last updated
07/20/2012
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