Provider Demographics
NPI:1902925142
Name:FUCHS, NINA A (MD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:A
Last Name:FUCHS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 GARVEY RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3071
Mailing Address - Country:US
Mailing Address - Phone:617-353-3575
Mailing Address - Fax:
Practice Address - Street 1:BOSTON UNIV STD HLTH SER
Practice Address - Street 2:881 COMMONWEALTH AVENUE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-353-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51766208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice