Provider Demographics
NPI:1992899975
Name:NIELDS, HENRY M (MD, PHD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:M
Last Name:NIELDS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 ALBANY ST
Mailing Address - Street 2:OFFICE OF THE CHIEF MEDICAL EXAMINER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2518
Mailing Address - Country:US
Mailing Address - Phone:617-267-6767
Mailing Address - Fax:
Practice Address - Street 1:720 ALBANY ST
Practice Address - Street 2:OFFICE OF THE CHIEF MEDICAL EXAMINER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2518
Practice Address - Country:US
Practice Address - Phone:617-267-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA78065207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology