Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 262546 | MA |
NPI | 1023024031 |
---|---|
Provider Name | Dr. Charles J Kert |
First Address | Fairhaven, MA 02719-5255 |
Second Address | Wareham, MA 02571-2097 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 22/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110104338A | (05) | MA |