Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 216541 | MA |
Y | 2080P0205X | Pediatric Endocrinologist | 216541 | MA |
NPI | 1245368406 |
---|---|
Provider Name | Dr. Jeremi M Carswell |
First Address | Sudbury, MA 01776-1915 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 17/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2130211 | (05) | MA |