Individual
PATRICIO FERNANDEZ VIVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 BOYLSTON ST, SUITE 112, CHESTNUT HILL, MA 02467-1715
(617) 277-2541
Mailing address
25 BOYLSTON ST, SUITE 112, CHESTNUT HILL, MA 02467-1715
(617) 277-2541
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
37971
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2033518
—
MA
Enumeration date
06/11/2006
Last updated
01/03/2013
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