Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 77636 | MA |
NPI | 1508853581 |
---|---|
Provider Name | Dr. Samuel Chow-Ern Pang |
First Address | Lexington, MA 02421-7305 |
Second Address | Lexington, MA 02421-7305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
077636 | TUFTS (01) | MA |
130069 | HARVARD PILGRIM (01) | MA |
E75740 | (02) | MA |
J13830 | BLUE CROSS BLUE SHIELD (01) | MA |