Individual
AMY S. COLWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15 PARKMAN ST, BOSTON, MA 02114-3117
(617) 643-5963
(617) 643-5964
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 643-5963
(617) 643-5964
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
207052
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110079072/A
—
MA
Enumeration date
11/07/2006
Last updated
12/10/2014
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