Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 46255 | MA |
N | 208200000X | Surgeon | 46255 | MA |
N | 208600000X | Surgeon | 46255 | MA |
N | 2086S0102X | Surgical Critical Care | 46255 | MA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 46255 | MA |
NPI | 1285653766 |
---|---|
Provider Name | Dr. Craig W Lillehei |
First Address | Chestnut Hill, MA 02467-2632 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B74176 | (02) |