Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 304483 | NY |
Y | 2081S0010X | Sports Medicine | 278825 | MA |
Y | 213ES0000X | Sports Medicine | 278825 | MA |
NPI | 1437544434 |
---|---|
Provider Name | Charles Scott |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 27/05/2020 |