Individual
ANDREW T. MITTELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 638-6800
Mailing address
BMC PROVIDER ENROLLMENT OFFICE, 960 MASSACHUSETTS AVE,.2ND FLOOR, BOSTON, MA 02118
(617) 414-5405
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
286802
MA
Other
Enumeration date
03/22/2017
Last updated
04/03/2024
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