Agus, Michael Sd

Agus, Michael Sd is an individual health care provider with primary practice located at 300 Longwood Ave Main 11 South, Boston MA 02115-5724. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Agus, Michael Sd can be contacted via phone (617) 355-5849.

Contact Information

Primary practice address
300 Longwood Ave Main 11 South Boston MA 02115-5724
Phone: (617) 355-5849
Fax: (888) 883-9238
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 157152 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 157152 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X 157152 Massachusetts

Profile Details

NPI number 1952382301
LBN Legal business name Agus, Michael Sd
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Apr 10th, 2014 - about 10 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 1952382301 NPPES
Massachusetts Other J19867 BCBS MA
Massachusetts MEDICAID 3197239 BCBS MA
Massachusetts Other 157152 BCBS MA

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