Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 75458 | MA |
N | 2080P0205X | Pediatric Endocrinologist | 75458 | MA |
NPI | 1043261225 |
---|---|
Provider Name | Dr. Harald W Jueppner |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3104397 | (05) | MA |
750102 | TUFTS HEALTH PLAN (01) | MA |
F47254 | (02) | |
J13407 | BCBS MA (01) | MA |