Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 238857 | MA |
NPI | 1366562159 |
---|---|
Provider Name | Dr. David C Dredge |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1274 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 19/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110082747A | (05) | MA |