Provider Demographics
NPI:1194750273
Name:SLESERS, JURIS (MD)
Entity type:Individual
Prefix:DR
First Name:JURIS
Middle Name:
Last Name:SLESERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 WORCESTER ST
Mailing Address - Street 2:#302
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481
Mailing Address - Country:US
Mailing Address - Phone:781-237-1733
Mailing Address - Fax:781-237-1736
Practice Address - Street 1:422 WORCESTER ST
Practice Address - Street 2:#302
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:US
Practice Address - Phone:781-237-1733
Practice Address - Fax:781-237-1736
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31799207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMS0090085AOtherDPH
MA2032848Medicaid
AS6649567OtherUS DEA
MA2032848Medicaid
AS6649567OtherUS DEA