Individual
JONATHAN VAN ORNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.B.A.
Contact information
Practice address
75 FRANCIS ST # 236A, BOSTON, MA 02115-6110
(617) 732-5500
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
273467
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2014
Last updated
12/30/2021
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