Individual
STEPHEN I PELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 HARRISON AVE, YACC5, BOSTON, MA 02118-4001
(617) 414-4841
(617) 414-7230
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
36674
MA
2080P0208X
Pediatric Infectious Diseases Physician
Primary
36674
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110036486A
—
MA
Enumeration date
11/21/2005
Last updated
07/09/2014
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