Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 2069 | MA |
Y | 213ES0103X | Foot & Ankle Surgery | 2069 | MA |
NPI | 1467532812 |
---|---|
Provider Name | Dr. Daniel M. Rutowicz |
First Address | Needham, MA 02494-3259 |
Second Address | Needham, MA 02494-3259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 30/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0307424 | (05) | MA |
1261920001 | DME (01) | MA |
U65685 | (02) | MA |