Moths-Rebrovic, Elisabeth Joan
Moths-Rebrovic, Elisabeth Joan is an individual health care provider with primary practice located at 415 Columbia Rd , Dorchester MA 02125-2424. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Moths-Rebrovic, Elisabeth Joan can be contacted via phone (617) 287-8000.Contact Information
Primary practice address
415 Columbia Rd
Dorchester MA 02125-2424
Phone: (617) 287-8000
Fax: (617) 740-8070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 58102 | Massachusetts |
Profile Details
| NPI number | 1558332270 |
|---|---|
| LBN Legal business name | Moths-Rebrovic, Elisabeth Joan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2006 |
| Last updated | Jan 13th, 2012 - about 12 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 | 1558332270 | NPPES |
| Massachusetts | MEDICAID | 3083101 |
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