Individual
DR. COSTAS MICHAELIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, VBK 830, BOSTON, MA 02114-2621
(617) 726-3311
Mailing address
1 DEVONSHIRE PL, APT 1502, BOSTON, MA 02109-3510
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
219175
MA
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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