Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 71296 | MA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 71296 | MA |
NPI | 1366468464 |
---|---|
Provider Name | Daniel M Estok II |
First Address | Brookline, MA 02445 |
Second Address | Boston, MA 02115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 06/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3071260 | (05) | MA |
E68366 | (02) |