Gervais, Debra A

Gervais, Debra A is an individual health care provider with primary practice located at 55 Fruit St Pll 2, Boston MA 02114-2621. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Gervais, Debra A can be contacted via phone (617) 726-8396.

Contact Information

Primary practice address
55 Fruit St Pll 2 Boston MA 02114-2621
Phone: (617) 726-8396
Fax: (617) 726-4891
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 81355 Massachusetts
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 81355 Massachusetts

Profile Details

NPI number 1558352450
LBN Legal business name Gervais, Debra A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Aug 21st, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558352450 NPPES
Massachusetts MEDICAID 3139832
Massachusetts Other 750293
Massachusetts Other J31339

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