Individual
DR. MELINDA JEAN FAN LERWILL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, WRN 2, BOSTON, MA 02114-2621
(617) 726-2967
(617) 726-7474
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
204794
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204794
TUFTS HEALTH PLAN
MA
05
—
3209393
—
MA
01
—
J22354
BCBS MA
MA
Enumeration date
11/03/2005
Last updated
07/08/2007
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