Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 45200 | MA |
NPI | 1003890955 |
---|---|
Provider Name | Dr. Richard C Mindess |
First Address | Springfield, MA 01104-2301 |
Second Address | Springfield, MA 01104-2301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 28/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6173713 | (05) | MA |
A56191 | (02) |