Provider Demographics
NPI:1245368406
Name:CARSWELL, JEREMI MOSS (MD)
Entity type:Individual
Prefix:DR
First Name:JEREMI
Middle Name:MOSS
Last Name:CARSWELL
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:BOSTON CHILDREN'S HOSPITAL - ENDOCRINOLOGY
Mailing Address - Street 2:300 LONGWOOD AVENUE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:508-341-7522
Mailing Address - Fax:
Practice Address - Street 1:BOSTON CHILDREN'S HOSPITAL - ENDOCRINOLOGY
Practice Address - Street 2:300 LONGWOOD AVENUE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-4367
Practice Address - Fax:617-730-6216
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2022-12-05
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2165412080P0205X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2130211Medicaid