Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 42075 | MA |
NPI | 1205810330 |
---|---|
Provider Name | Dr. Peter E Newburger |
First Address | Boston, MA 02241-0001 |
Second Address | Worcester, MA 01655-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0113204 | (05) | MA |
D88132 | (02) | MA |