Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 219758 | MA |
NPI | 1053354852 |
---|---|
Provider Name | Dr. Ekkehard Matthias Kasper |
First Address | Boston, MA 02215 |
Second Address | Boston, MA 02215-5501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 15/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2086476 | (05) | MA |
I22907 | (02) | MA |