Individual
SAMARA JO SORUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5491
(617) 754-4677
Mailing address
330 BROOKLINE AVE, BOSTON, MA 02215-5491
(617) 754-4677
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A186009
CA
208000000X
Pediatrics Physician
A186009
CA
208M00000X
Hospitalist Physician
Primary
1018879
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2020
Last updated
07/16/2024
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