Phan, Mai Truc

Phan, Mai Truc is an individual health care provider with primary practice located at 388 Commonwelath Ave Mbb Mgh Back Bay, Boston MA 02215-2800. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Phan, Mai Truc can be contacted via phone (617) 267-7171.

Contact Information

Primary practice address
388 Commonwelath Ave Mbb Mgh Back Bay Boston MA 02215-2800
Phone: (617) 267-7171
Fax: (617) 262-2608
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 153182 Massachusetts

Profile Details

NPI number 1255321998
LBN Legal business name Phan, Mai Truc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Nov 26th, 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 1255321998 NPPES
Massachusetts MEDICAID 3167488
Massachusetts Other J17866
Massachusetts Other 153182

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