Individual
JOHN HOPKINS FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-9674
Mailing address
330 MOUNT AUBURN ST, PARSONS 2, CAMBRIDGE, MA 02138-5597
(617) 354-8771
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1019462
MA
207R00000X
Internal Medicine Physician
314912
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
1019462
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
3013552
MA
207RP1001X
Pulmonary Disease Physician
1019462
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2019
Last updated
01/21/2026
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