Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 279845 | MA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 56633 | MN |
N | 207YP0228X | Pediatric Otolaryngology | 51120 | SC |
NPI | 1649534546 |
---|---|
Provider Name | Alexander Philip Marston |
First Address | Boston, MA 02119-3791 |
Second Address | Boston, MA 02118-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 21/12/2020 |