Organization
BOSTON UNIVERSITY FAMILY MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN A. WILSON M.D. (PRESIDENT)
(617) 414-2080
Entity
Organization
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 414-2080
(617) 414-2090
Mailing address
960 MASSACHUSETTS AVE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110072644A
—
MA
05
—
3114929
—
NH
Enumeration date
05/31/2006
Last updated
12/20/2023
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