Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 33259 | MA |
NPI | 1003897711 |
---|---|
Provider Name | Dr. Martin Stanley Hirsch |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
033259 | TUFTS HEALTH PLAN (01) | MA |
2056704 | (05) | MA |
D94172 | (02) | |
M08082 | BCBS MA (01) | MA |