Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 44147 | MA |
NPI | 1073550729 |
---|---|
Provider Name | David H Bor |
First Address | Cambridge, MA 02139-1047 |
Second Address | Cambridge, MA 02139-1047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 02/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0128503 | (05) | MA |
B99435 | (02) | |
E05456 | BCBS MA (01) | MA |