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MR. STEPHEN EDWARD MCDONOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
75 FRANCIS ST, BOSTON, MA 02115-6106
(617) 732-7678
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6106
(617) 732-7678

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA100085
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA100085
MASSACHUSETTS PHYSICIAN ASSISTANT LICENSE
MA
Enumeration date
05/25/2022
Last updated
12/28/2023
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