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Individual

MICHELLE P DURHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D., M.P.H.

Contact information

Practice address
ONE BOSTON MEDICAL CENTER PLACE, BOSTON, MA 02118-4001
(617) 414-5245
(617) 638-6836
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
259044
MA
2084P0804X
Child & Adolescent Psychiatry Physician
259044
MA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
U1887
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110101175A
MA
Enumeration date
06/17/2009
Last updated
02/16/2024
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