Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 32773 | MA |
N | 208600000X | Surgeon | 32773 | MA |
N | 2086S0129X | Vascular Surgeon | 32773 | MA |
NPI | 1114918034 |
---|---|
Provider Name | Dr. David Charles Brewster |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2042401 | (05) | MA |
707161 | TUFTS HEALTH PLAN (01) | MA |
A65958 | (02) | |
M07786 | BCBS MA (01) | MA |