Individual
MIA SUSAN DESIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-8613
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
286373
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271625
—
MA
Enumeration date
07/06/2017
Last updated
02/11/2026
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