Individual
DR. MENNO VERHAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7289
(617) 730-0496
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7289
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
52954
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3031780
—
MA
Enumeration date
08/07/2006
Last updated
08/16/2007
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