Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 32891 | MA |
NPI | 1003802026 |
---|---|
Provider Name | Dr. Bertram Zarins |
First Address | Boston, MA 02114-2743 |
Second Address | Boston, MA 02114-2743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 04/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2055783 | (05) | MA |
A66017 | (02) | MA |