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Contact Information

MICHAEL B TANTILLO, MD
25 BOYLSTON STREET
SUITE 304
CHESTNUT HILL, MA02467
 Phone: 617-505-6818
 Fax: 617-505-6813
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MICHAEL B TANTILLO · (Male)

NPI # 1841281227
Status Active
Credentials MD
Entity Individual
Enumeration date 11/03/2005
Last updated 11/30/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 74194
  • NH License # 19264
  • MA Medicaid 3192873
Hospital affiliation(s)
  • ST ELIZABETH'S MEDICAL CENTER - (Acute Care)
    736 CAMBRIDGE STREET
    BRIGHTON, MA 02135
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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