Organization
INNOVATIVE MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD C BOUSQUET MD (PRESIDENT)
(617) 232-2003
Entity
Organization
Contact information
Practice address
70 PARKER HILL AVE, SUITE 3406, ROXBURY CROSSING, MA 02120-3224
(617) 232-2003
(617) 975-0768
Mailing address
70 PARKER HILL AVE, SUITE 3406, ROXBURY CROSSING, MA 02120-3224
(617) 232-2003
(617) 975-0768
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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