Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | EC-05-086 | ME |
N | 208600000X | Surgeon | EC-05-086 | ME |
Y | 2086S0102X | Surgical Critical Care | 244347 | MA |
N | 2086S0102X | Surgical Critical Care | 32081 | SC |
NPI | 1144398926 |
---|---|
Provider Name | Andrew R Doben |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1270 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 16/05/2016 |