Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 259072 | MA |
N | 111NI0900X | Internist | 259072 | MA |
NPI | 1003109364 |
---|---|
Provider Name | Dr. Brian Thomas Halbert |
First Address | Boston, MA 02215-5521 |
Second Address | Boston, MA 02215-5400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2011 |
Last Update Date | 15/08/2016 |