Individual
JUAN E SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
41 MALL RD, LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-8170
(781) 744-5232
Mailing address
41 MALL RD, LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-8170
(781) 744-5232
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
223621
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110075549A
—
MA
Enumeration date
11/27/2006
Last updated
03/04/2011
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