Individual
JOHN FIADJOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
(267) 425-9331
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD423799
PA
207LP3000X
Pediatric Anesthesiology Physician
Primary
286278
MA
207LP3000X
Pediatric Anesthesiology Physician
MD423799
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016180790
—
PA
01
—
183049EJL
MEDICARE PTAN
PA
Enumeration date
08/23/2006
Last updated
04/09/2021
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