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Board of Medicine Address
  Commonwealth of Massachusetts
  Board of Registration in Medicine
  560 Harrison Avenue, Suite G-4
  Boston, MA 02118
  (617) 654-9800
  (617) 423-5604 TTY

  Hours M-F; 8:45 a.m. to 5:00 p.m.

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Online Address Change

To complete your address change by mail or fax, click here.

* = Mandatory Field

*Last Name:
*First Name:
Email Address:
Fax Number:
*License Number:
*Date of Birth:	(mm/dd/yyyy)

Mailing Address
Address 1:
Address 2:

City:		State:
Zip:		Country:
Phone:		Extension:

Business Address
Address 1:
Address 2:

City:		State:
Zip:		Country:
Phone:		Extension:

Home Address
Address 1:
Address 2:

City:		State:
Zip:		Country:
Phone:		Extension:

Address Change by Mail or Fax

By Mail:
          Complete the form found here and mail it to:

          Commonwealth of Massachusetts
          Board of Registration in Medicine
          560 Harrison Avenue, Suite G-4
          Boston, MA 02118
          Attn: Address Changes

By Fax:
Complete the form found here and fax it to:

(617) 426-9358

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