Organization
AMERICAN WELL PHYSICIANS MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER ANTALL (PRESIDENT)
(617) 204-3500
Entity
Organization
Contact information
Practice address
75 STATE ST FL 26, BOSTON, MA 02109-1827
(617) 204-3500
Mailing address
75 STATE ST FL 26, BOSTON, MA 02109-1827
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
09/25/2013
Last updated
01/14/2015
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