Individual
DR. MITCHELL OWEN TUNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1153 CENTRE ST, SUITE 31, BOSTON, MA 02130-3446
(617) 522-3100
(617) 522-6366
Mailing address
27 MAY ST, BOSTON, MA 02130-3032
(617) 524-9524
(617) 522-6366
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
55132
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3024377
—
MA
Enumeration date
07/11/2006
Last updated
07/08/2007
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