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1134786056
GREGORY LYLE YUNGTUM
BOSTON, MA
NPI
1134786056
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: MA 292064)
Enumeration Date
2019-05-27
Last Update Date
2022-06-30
Business Address
GREGORY LYLE YUNGTUM MD
55 FRUIT ST
BOSTON, MA 02114-2696
Phone number: 319-239-9378
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Mailing Address
GREGORY LYLE YUNGTUM MD
55 FRUIT ST
BOSTON, MA 02114-2696
Phone number: 319-239-9378
Copy
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