Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 2086S0102X | MA |
NPI | 1316359631 |
---|---|
Provider Name | Dr. Adam Michael Ackerman |
First Address | Boston, MA 02114-2696 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2014 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
284292 | MASSACHUSETTS BOARD OF MEDICINE (01) | MA |