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Individual

DR. JOREN CHRISTIAN MADSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD DPHL

Contact information

Practice address
55 FRUIT ST, BUL 119, BOSTON, MA 02114-2621
(617) 724-1130
(617) 726-1821
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 643-4808
(617) 643-4582

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
72269
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
72269
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
072269
TUFTS HEALTH PLAN
MA
05
3108244
MA
01
J13389
BCBS MA
MA
Enumeration date
11/23/2005
Last updated
07/19/2012
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