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Individual

DR. JEAN R ELRICK

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
55 FRUIT ST, BUL 240D, BOSTON, MA 02114-2621
(617) 726-0430
(617) 724-3377
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
59691
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
059691
TUFTS HEALTH PLAN
MA
05
3072169
MA
01
J10524
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
07/08/2007
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