Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 1452 | MA |
NPI | 1457321630 |
---|---|
Provider Name | Dr. Edward Soloway |
First Address | Burlington, MA 01803-0107 |
Second Address | Winchester, MA 01890-1921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 20/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0382774 | (05) | MA |
33187 | PILGRIM (01) | MA |