Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 80130 | MA |
NPI | 1841240751 |
---|---|
Provider Name | Dr. James M Shenko |
First Address | Worcester, MA 01605-3646 |
Second Address | Sterling, MA 01564-2156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 29/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3134181 | (05) | MA |