Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 050615 | CT |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 273115 | MA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 050615 | CT |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 273115 | MA |
NPI | 1184808131 |
---|---|
Provider Name | Dr. Matthew David Milewski |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2007 |
Last Update Date | 26/10/2017 |