Provider Demographics
NPI:1982913844
Name:DE FERAUDY, SEBASTIEN MARIE GERARD (MD-PHD)
Entity type:Individual
Prefix:DR
First Name:SEBASTIEN
Middle Name:MARIE GERARD
Last Name:DE FERAUDY
Suffix:
Gender:M
Credentials:MD-PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:40 SAINT BOTOLPH ST APT 38
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-6419
Mailing Address - Country:US
Mailing Address - Phone:415-994-6761
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL, DEPARTMENT OF PATHOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-5700
Practice Address - Fax:617-232-9820
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2021-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA240152390200000X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program