Individual
DR. DEANNA L COREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 ALBANY ST, SHAPIRO 4, SUITE 4B, BOSTON, MA 02118-2526
(617) 638-5633
(617) 414-5226
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
261121
MA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
261121
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT196644
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
PA
Enumeration date
06/23/2010
Last updated
10/10/2014
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