Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 257361 | MA |
N | 207T00000X | Neurosurgeon | 36176 | AZ |
N | 207T00000X | Neurosurgeon | ME0095822 | FL |
NPI | 1003860735 |
---|---|
Provider Name | Dr. Mohammad Ali Aziz-Sultan |
First Address | Boston, MA 02115-6110 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 24/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
275472000 | (05) | FL |
53137 | (02) | FL |