Desimone, Mia Susan
Desimone, Mia Susan is an individual health care provider with primary practice located at 75 Francis St , Boston MA 02115-6110. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Desimone, Mia Susan can be contacted via phone (617) 732-8613.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 286373 | Massachusetts |
Profile Details
| NPI number | 1336660778 |
|---|---|
| LBN Legal business name | Desimone, Mia Susan |
| Credentials | MD, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2017 |
| Last updated | Mar 23rd, 2022 - about 2 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 | 1336660778 | NPPES |
| Massachusetts | MEDICAID | 271625 |
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