Grevelink, Joannes M
Grevelink, Joannes M is an individual health care provider with primary practice located at 30 Lancaster Street Suite 400, Boston MA 02114. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Grevelink, Joannes M can be contacted via phone (617) 722-4100.Contact Information
Primary practice address
30 Lancaster Street Suite 400
Boston MA 02114
Phone: (617) 722-4100
Fax: (617) 227-1134
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 60705 | Massachusetts |
Profile Details
| NPI number | 1538150982 |
|---|---|
| LBN Legal business name | Grevelink, Joannes M |
| Credentials | MD PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2005 |
| Last updated | May 13th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538150982 | NPPES |
| Massachusetts | MEDICAID | 3057623 | |
| Massachusetts | Other | 060705 | |
| Massachusetts | Other | J08910 |
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