Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 48931 | MA |
NPI | 1043290752 |
---|---|
Provider Name | Clayland F Cox |
First Address | South Weymouth, MA 02190-1547 |
Second Address | South Weymouth, MA 02190-1547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0187542 | (05) | MA |
B99391 | (02) | MA |