Individual
DR. JONATHAN BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 1ST AVE, SRH SPAULDING REHAB HOSPITAL, BOSTON, MA 02129-3109
(617) 952-6800
(617) 573-2727
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 952-6800
(617) 573-2759
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
77970
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
077970
TUFTS HEALTH PLAN
MA
05
—
3112730
—
MA
01
—
J14109
BCBS MA
MA
Enumeration date
11/07/2005
Last updated
08/22/2016
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