Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 36527 | MA |
Y | 208600000X | Surgeon | 36527 | MA |
N | 208200000X | Surgeon | 36527 | MA |
N | 208600000X | Surgeon | 36527 | MA |
NPI | 1003876384 |
---|---|
Provider Name | Dr. Matthias Bernard Donelan |
First Address | Newton Lower Falls, MA 02462-1655 |
Second Address | Newton Lower Falls, MA 02462-1655 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 03/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A54263 | (02) |