Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 214873 | MA |
N | 208200000X | Surgeon | 214873 | MA |
N | 208600000X | Surgeon | 214873 | MA |
N | 2086S0120X | Pediatric Surgery | 0101246316 | VA |
N | 2086S0120X | Pediatric Surgery | 04-38546 | KS |
N | 2086S0120X | Pediatric Surgery | 2016003924 | MO |
NPI | 1093839789 |
---|---|
Provider Name | Bartholomew John Kane III |
First Address | Burlington, MA 01805-0001 |
Second Address | Burlington, MA 01805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 28/05/2019 |