Individual
DR. CHAD JASON JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
221 LONGWOOD AVE, BOSTON, MA 02115-5804
(617) 732-4918
Mailing address
221 LONGWOOD AVE, BOSTON, MA 02115-5804
(617) 732-4918
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
242817
MA
207ND0900X
Dermatopathology Physician
242817
MA
Other
Enumeration date
08/15/2008
Last updated
10/18/2018
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