Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 1830 | MA |
NPI | 1144409749 |
---|---|
Provider Name | Dr. James Edward Dwyer |
First Address | Weymouth, MA 02188-3302 |
Second Address | Weymouth, MA 02188-3302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2007 |
Last Update Date | 31/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0361887 | (05) | MA |
T58791 | (02) | MA |