Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 216088 | MA |
NPI | 1104076132 |
---|---|
Provider Name | Donald W Marion |
First Address | Wayland, MA 01778-3607 |
Second Address | Wayland, MA 01778-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2008 |
Last Update Date | 26/09/2008 |