Individual
DR. JOHN L NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 MERRIMAC ST, 1ST FLOOR, BOSTON, MA 02114-4724
(617) 726-4132
(617) 726-4213
Mailing address
101 MERRIMAC ST, 1ST FLOOR, SUITE 7, BOSTON, MA 02114-4724
(617) 726-4132
(617) 726-4213
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
54243
MA
207RN0300X
Nephrology Physician
Primary
54243
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110045431/A
—
MA
01
—
724621
TUFTS HEALTH PLAN
MA
01
—
J07173
BCBS MA
MA
Enumeration date
02/17/2006
Last updated
02/04/2015
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