Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 44532 | MA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 44532 | MA |
NPI | 1265531552 |
---|---|
Provider Name | David Boland |
First Address | Fall River, MA 02720-5246 |
Second Address | Fall River, MA 02720-5246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 09/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6177999 | (05) | MA |
A56881 | (02) |