Individual
DR. TAMARA G. FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-4074
Mailing address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-4074
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
213567
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0194921
—
MA
Enumeration date
06/30/2006
Last updated
09/06/2007
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