Individual
DR. SJIRK J WESTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, FND 2, BOSTON, MA 02114-2621
(617) 724-4207
(617) 726-8360
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-4207
(617) 726-8360
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
207904
MA
2085R0202X
Diagnostic Radiology Physician
Primary
207904
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0126918
—
MA
01
—
207904
TUFTS HEALTH PLAN
MA
01
—
J23155
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
07/25/2012
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