Individual
DR. MYECHIA MINTER-JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MBA
Contact information
Practice address
55 DIMOCK ST, ROXBURY, MA 02119-1029
(617) 442-8800
Mailing address
55 DIMOCK ST, ROXBURY, MA 02119-1029
(617) 442-8800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
230963
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
803402800
—
MD
Enumeration date
05/10/2006
Last updated
06/01/2010
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