Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 150536 | MA |
N | 207X00000X | Orthopaedic Surgeon | MD09246 | RI |
N | 207XS0106X | Orthopaedic Hand Surgeon | 150536 | MA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD09246 | RI |
NPI | 1033166764 |
---|---|
Provider Name | Dr. Marco P Dirks |
First Address | Attleboro, MA 02703-3511 |
Second Address | Attleboro, MA 02703-3511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 04/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A22232 | (02) | MA |