Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 56662 | MA |
Y | 207YS0123X | Facial Plastic Surgeon | 56662 | MA |
NPI | 1306832316 |
---|---|
Provider Name | Dr. Mack Lowell Cheney |
First Address | Boston, MA 02114-3002 |
Second Address | Boston, MA 02114-3002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 22/06/2015 |