Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 211623 | MA |
N | 208600000X | Surgeon | 211623 | MA |
Y | 2082S0105X | Plastic Hand Surgeon | 211623 | MA |
NPI | 1982665485 |
---|---|
Provider Name | Dr. Jonathan Michael Winograd |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-3117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2006 |
Last Update Date | 13/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0150321 | (05) | MA |
211623 | TUFTS HEALTH PLAN (01) | MA |
H47503 | (02) | |
J23747 | BCBS MA (01) | MA |