Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 154875 | MA |
NPI | 1003890021 |
---|---|
Provider Name | Dr. Clifford Bierman |
First Address | Westwood, MA 02090-2321 |
Second Address | Westwood, MA 02090-2321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 19/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3170136 | (05) | MA |
G52320 | (02) |