Individual
JOHN JOSEPH CLOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 VFW PKWY, EMERGENCY DEPARTMENT, WEST ROXBURY, MA 02132-4927
(617) 323-7700
(857) 203-5645
Mailing address
761 E 6TH ST APT 19, BOSTON, MA 02127-4341
(617) 269-5111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
150879
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3176291
—
MA
01
—
39-00216
UNITED HEALTH CARE
MA
01
—
J17245
BLUE SHIELD
MA
Enumeration date
09/12/2006
Last updated
07/08/2007
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