Individual
MS. ELISABETH JOAN MOTHS-REBROVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
415 COLUMBIA RD, DORCHESTER, MA 02125-2424
(617) 287-8000
(617) 740-8070
Mailing address
415 COLUMBIA RD, DORCHESTER, MA 02125-2424
(617) 287-8000
(617) 740-8070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
58102
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3083101
—
MA
Enumeration date
01/30/2006
Last updated
01/13/2012
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