Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 30420 | MA |
N | 207VX0000X | Obstetrician | 30420 | MA |
NPI | 1255391256 |
---|---|
Provider Name | Dr. John H Derry |
First Address | Sudbury, MA 01776 |
Second Address | Lexington, MA 02421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 08/07/2007 |