Individual
DR. FREDERIC JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MSC, FRCSC
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-8258
Mailing address
1365 BOYLSTON ST UNIT 948, BOSTON, MA 02215-3918
(857) 284-2301
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
250877
MA
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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