Individual
ELLIOTT C. FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 414-5481
Mailing address
BMC PROVIDER ENROLLMENT OFFICE, 960 MASSACHUSETTS AVE,.2ND FLOOR, BOSTON, MA 02118
(617) 414-5405
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
290835
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110153643A
—
MA
Enumeration date
04/07/2019
Last updated
08/28/2024
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