Individual
MICHELLE LI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114
(617) 726-4600
Mailing address
1 NASHUA STREET, 1410, BOSTON, MA 02114
(718) 433-7468
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
56954
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100561300
—
KY
Enumeration date
06/24/2014
Last updated
11/22/2019
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