Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 262506 | MA |
N | 208000000X | Pediatrician | 262506 | MA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 262506 | MA |
N | 2080P0203X | Pediatric Critical Care Doctor | A116860 | CA |
NPI | 1023270238 |
---|---|
Provider Name | Dr. Aaron Spicer |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2008 |
Last Update Date | 15/08/2019 |