Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME0016216 | FL |
NPI | 1225004849 |
---|---|
Provider Name | Dr. Alfred Robert Massam |
First Address | Sebring, FL 33870 |
Second Address | Sebring, FL 33870 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 13/02/2019 |