Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 154747 | MA |
NPI | 1083606016 |
---|---|
Provider Name | Dr. Anna E. Petropoulos |
First Address | Danvers, MA 01923-2135 |
Second Address | Danvers, MA 01923-2135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 11/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19916 | HARVARD PILGRIM (01) | MA |
BP6821599 | DEA (01) | MA |
H44169 | (02) | MA |