Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 53857 | MA |
Y | 111NI0900X | Internist | 53857 | MA |
N | 207RA0401X | Internist - Addiction Medicine | 53857 | MA |
NPI | 1710993084 |
---|---|
Provider Name | Dr. Jeffrey H. Samet |
First Address | Boston, MA 02119-2560 |
Second Address | Boston, MA 02118-2605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110065625A | (05) | MA |