Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 233003 | MA |
N | 208600000X | Surgeon | 233003 | MA |
N | 2086S0105X | Surgery of the Hand | 254385 | MA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 254385 | MA |
NPI | 1386844165 |
---|---|
Provider Name | Dr. Kyle R. Eberlin |
First Address | Boston, MA 02114-2621 |
Second Address | Boston, MA 02114-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 19/07/2013 |