Individual
STEPHANIE P CORRADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, YAW 6C, BOSTON, MA 02114-2621
(617) 726-2730
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301087129
MI
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
4301087129
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2040336
—
MA
05
—
4858334
—
MI
01
—
J27345
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/25/2006
Last updated
09/11/2025
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