Bordeaux, Jeremy S
Bordeaux, Jeremy S is an individual health care provider with primary practice located at 281 Lincoln Street Umass Dermatology Hahnemann Campus, Worcester MA 01605. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Bordeaux, Jeremy S can be contacted via phone (508) 334-5971.Contact Information
Primary practice address
281 Lincoln Street Umass Dermatology Hahnemann Campus
Worcester MA 01605
Phone: (508) 334-5971
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 35-089926 | Ohio |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 228008 | Massachusetts |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | 35-089926 | Ohio |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 35-089926 | Ohio |
Profile Details
| NPI number | 1043242589 |
|---|---|
| LBN Legal business name | Bordeaux, Jeremy S |
| Credentials | MD MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Dec 17th, 2020 - about 4 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 | 1043242589 | NPPES |
| Ohio | MEDICAID | 2771522 | |
| Ohio | Other | 000000524092 | |
| Ohio | Other | P00406576 | |
| Ohio | Other | 000000221131 | |
| Ohio | Other | 750496 | |
| Ohio | Other | 5569102 | |
| Ohio | Other | 414951 |
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