Individual
DEREK SVEN STENQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MASSACHUSETTS GENERAL HOSPITAL, 55 FRUIT ST., BOSTON, MA 02114
(617) 726-2942
Mailing address
75 PUTNAM ST, NEEDHAM, MA 02494-2223
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
267312
MA
207X00000X
Orthopaedic Surgery Physician
ME148525
FL
207XX0801X
Orthopaedic Trauma Physician
Primary
278911
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
278911
COMMONWEALTH OF MASSACHUSETTS
MA
01
—
ME148525
STATE LICENSE
FL
Enumeration date
05/24/2016
Last updated
08/30/2022
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