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Individual

DR. BURT D PINA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 FRUIT STREET FND 2, BOSTON, MA 02114-2696
(617) 573-2064
(617) 724-4254
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35000
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3046494
MA
01
732896
TUFTS HEALTH PLAN
MA
01
J08384
BCBS MA
MA
Enumeration date
11/10/2005
Last updated
07/08/2007
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