Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207R00000X | Internal Medicine | | 41598 | MASSACHUSETTS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 0401729 | OTHER | | EVERCARE |
| 2 | 784142 | OTHER | | MVP HEALTH CARE |
| 3 | 26888 | OTHER | | HEALTHY START |
| 4 | N01819 | OTHER | | BLUE SHIELD INDEMNITY |
| 5 | 042472266 | OTHER | | ONE HEALTH PLAN |
| 6 | AA1206 | OTHER | | HARVARD PILGRIM HEALTHCAR |
| 7 | 042472266 | OTHER | | HEALTHCARE VALUE MANAGEME |
| 8 | 26888 | OTHER | | CHILDRENS MEDICAL SECURIT |
| 9 | N01819 | OTHER | | BLUE CARE ELECT |
| 10 | 7636511 | OTHER | | CIGNA HEALTH PLAN |
| 11 | WELFARE | OTHER | | 3099571 |
| 12 | 7407335 | OTHER | | AETNA US HEALTHCARE |
| 13 | 9900074 | OTHER | | FALLON COMMUNITY HEALTH |
| 14 | N01819 | OTHER | | BLUE SHIELD HMO BLUE |
| 15 | 042472266 | OTHER | | PRIVATE HEALTHCARE SYSTEM |
| 16 | 917744 | OTHER | | FIRST HEALTH |
