Fewkes, Jessica L.

Fewkes, Jessica L. is an sole proprietor health care provider with primary practice located at 243 Charles St , Boston MA 02114-3002. She recently has only one registered license in Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, which is considered as her primary health care specialty. Fewkes, Jessica L. can be contacted via phone (617) 573-4102.

Contact Information

Primary practice address
243 Charles St Boston MA 02114-3002
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 50939 Massachusetts

Profile Details

NPI number 1295726396
LBN Legal business name Fewkes, Jessica L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2005
Last updated Nov 7th, 2011 - about 13 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 1295726396 NPPES
Massachusetts MEDICAID 6172903

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