Organization
BAY STATE UROLOGISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY DAVID MITCHESON MD (PRESIDENT)
(617) 782-1200
Entity
Organization
Contact information
Practice address
521 MOUNT AUBURN ST STE 201, WATERTOWN, MA 02472-4153
(617) 926-1200
(617) 926-5195
Mailing address
521 MOUNT AUBURN ST STE 201, WATERTOWN, MA 02472-4153
(617) 926-1200
(617) 926-5195
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9723749
—
MA
Enumeration date
08/09/2005
Last updated
08/09/2023
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