Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 160708 | MA |
N | 111NI0900X | Internist | 160708 | MA |
Y | 207RI0200X | Infectious Disease | 160708 | MA |
NPI | 1003912510 |
---|---|
Provider Name | David James Thornton |
First Address | West Roxbury, MA 02132-4927 |
Second Address | West Roxbury, MA 02132-4927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 05/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0135551 | (05) | MA |