Individual
DR. JIANREN MAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
15 PARKMAN ST, WAC 324 ANESTHESIA PAIN MANAGEMENT, BOSTON, MA 02114-3117
(617) 726-8810
(617) 724-3441
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-8810
(617) 726-3441
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
159628
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
159628
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159628
TUFTS HEALTH PLAN
MA
05
—
3195007
—
MA
01
—
J19914
BCBS MA
MA
Enumeration date
10/31/2005
Last updated
12/13/2012
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