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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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