Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 266959 | MA |
N | 207RH0002X | Hospice and Palliative Medicine | 1053657270 | IL |
NPI | 1114280310 |
---|---|
Provider Name | Dr. Mark Stoltenberg |
First Address | Boston, Ma 02114, MA 02114 |
Second Address | Boston, MA 02114-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 19/09/2016 |