Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 150240 | MA |
N | 207YS0123X | Facial Plastic Surgeon | 150240 | MA |
NPI | 1669463782 |
---|---|
Provider Name | Dr. Mark F. Rounds |
First Address | Boston, MA 02119-2020 |
Second Address | Newton, MA 02462-1650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 14/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2041367 | (05) | MA |
G55421 | (02) | MA |