Individual
DR. MILTON ROBERT AVERY GHOLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 OCEAN AVE, REVERE, MA 02151-3675
(781) 485-6000
Mailing address
300 OCEAN AVE, REVERE, MA 02151-3675
(781) 485-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
291720
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2019
Last updated
07/20/2022
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