Individual
ANTONIO DE LAS MORENAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
670 ALBANY ST, 3RD FLOOR, BOSTON, MA 02118-2518
(617) 414-5314
(617) 414-5315
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
53324
MA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2018-02510
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30204459
—
NH
05
—
3043398
—
MA
Enumeration date
02/08/2006
Last updated
10/02/2018
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