Individual
MATTIE ELIZABETH RAIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(585) 275-5168
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
(912) 293-4901
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1022697
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2019
Last updated
06/09/2025
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