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Provider Information for 1023045127

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. DIEGO PORRAS INGOUVILLE MD

Gender: MALE

Individual NPI: 1023045127

Calendar   Last Updated:  2020-10-06
  Certification Date:  2020-10-06

Details

Name Value
NPI 1023045127
Enumeration Date 2006-06-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE
BOSTON, MA 02115
United States

Phone: 617-355-6000 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE
BOSTON, MA 02115
United States

Phone: 617-355-6000 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other TAX ID 620476822
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207RI0011X - Internal Medicine Interventional Cardiology MA 241562
No 2080P0202X - Pediatrics Pediatric Cardiology MA 241562