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Contact Information

JASON A FAWLEY, MD
15 PARKMAN STREET
CHURCHILL SURGICAL CLINIC
BOST, MA02114-3117
 Phone: 617-643-7557
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JASON A FAWLEY · (Male)

NPI Number 1114218146
Status Active
Credentials MD
Entity Individual
Enumeration date 04/25/2011
Last updated 10/04/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 280467
  • WI Medicaid 1114218146
Hospital affiliation(s)
  • MASSACHUSETTS GENERAL HOSPITAL - (Acute Care)
    55 FRUIT STREET
    BOSTON, MA 02114
  • NEWTON-WELLESLEY HOSPITAL - (Acute Care)
    2014 WASHINGTON STREET
    NEWTON, MA 02462
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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