Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 153089 | MA |
N | 207VX0000X | Obstetrician | 153089 | MA |
NPI | 1295709392 |
---|---|
Provider Name | Dr. Melissa J Clough |
First Address | Milford, MA 01757 |
Second Address | Milford, MA 01757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 16/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G59651 | (02) |