Basic Information
Provider Information
NPI: 1528025996
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOLOMON
FirstName: SCOTT
MiddleName: DAVID
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 375 BOYLSTON ST
Address2:  
City: BROOKLINE
State: MA
PostalCode: 024456007
CountryCode: US
TelephoneNumber: 8573070896
FaxNumber: 8573070899
Practice Location
Address1: 75 FRANCIS ST PBB1
Address2: BRIGHAM AND WOMENS HOSPITAL CARDIOVASCULAR DIVISION
City: BOSTON
State: MA
PostalCode: 02115
CountryCode: US
TelephoneNumber: 6177327182
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/28/2006
LastUpdateDate: 03/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X60372MAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


Home