Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | D53982 | MD |
N | 208200000X | Surgeon | 2019-02109 | NC |
N | 208600000X | Surgeon | 2019-02109 | NC |
N | 208200000X | Surgeon | D53982 | MD |
N | 208600000X | Surgeon | D53982 | MD |
Y | 2082S0105X | Plastic Hand Surgeon | 2019-02109 | NC |
N | 2082S0105X | Plastic Hand Surgeon | D53982 | MD |
NPI | 1619912466 |
---|---|
Provider Name | Dr. Eagen Gene Deune |
First Address | Boston, MA 02119-3791 |
Second Address | Boston, MA 02118-3549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
435100200 | (05) | MD |
G05247 | (02) | MD |