Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 79457 | MA |
NPI | 1225097132 |
---|---|
Provider Name | Dr. Akiko Shimamura |
First Address | Needham, MA 02492-1217 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 06/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3132633 | (05) | MA |
F83801 | (02) |