Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 274393 | MA |
NPI | 1053755611 |
---|---|
Provider Name | Dr. Margo Rockwell Stevenson |
First Address | Florence, MA 01062-2003 |
Second Address | Wilbraham, MA 01095-1254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2013 |
Last Update Date | 11/12/2018 |