Organization
ENT SURGERY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JAMOULIS JAMESON M.D. (OWNER)
(617) 499-9933
Entity
Organization
Contact information
Practice address
725 CONCORD AVE, 2300, CAMBRIDGE, MA 02138-1040
(617) 499-9933
(617) 499-9935
Mailing address
725 CONCORD AVE, 2300, CAMBRIDGE, MA 02138-1040
(617) 499-9933
(617) 499-9935
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
72421
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110049047
—
MA
Enumeration date
03/06/2013
Last updated
03/06/2013
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