Individual
SIAM OOTTAMASATHIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-0327
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-0327
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
6513463-1205
UT
2088P0231X
Pediatric Urology Physician
Primary
6513463-1205
UT
Other
Enumeration date
01/04/2007
Last updated
12/05/2017
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