Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 48368 | MA |
NPI | 1073510756 |
---|---|
Provider Name | Dr. Laura Linda Mccann |
First Address | Wellesley, MA 02481-1711 |
Second Address | Wellesley, MA 02481-1711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 14/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B77250 | (02) |