Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 256138 | MA |
NPI | 1992134662 |
---|---|
Provider Name | Dr. Mathilde Hupin Debeurme |
First Address | Boston, MA 02130-1011 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2013 |
Last Update Date | 04/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AC1220007-MH163295 | DEA NUMBER (01) | MA |
MA0111714-MH163295 | MA CS# (01) | MA |