Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 250922 | MA |
Y | 207VX0201X | Gynecologic Oncologist | 250922 | MA |
NPI | 1326201906 |
---|---|
Provider Name | Dr. Kevin M. Elias |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 03/09/2020 |