Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 283166 | MA |
NPI | 1396192142 |
---|---|
Provider Name | Adam Harris |
First Address | Boston, MA 02215-5400 |
Second Address | Boston, MA 02120-2847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2016 |
Last Update Date | 09/09/2021 |