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Individual

MR. STEPHEN E SALLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
450 BROOKLINE AVENUE, ROOM 1642, BOSTON, MA 02215-5450
(617) 632-3316
(617) 632-5511
Mailing address
450 BROOKLINE AVE, ROOM 1642, BOSTON, MA 02215-5418
(617) 632-3316
(617) 632-5511

Taxonomy

Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
33196
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000025975
BMC HEALTHNET
01
033196
TUFTS
01
2042894
MASSHEALTH
MA
01
23315
FALLON COMMUNITY HEALTH P
01
2937823
AETNA US HEALTHCARE
01
4149019
CIGNA
01
D88890DF
HCHC DFCI ONLY
01
M08754
BCBS INDEMNITY ELECT HMO
MA
Enumeration date
03/17/2006
Last updated
04/04/2012
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