Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 259766 | MA |
NPI | 1013202662 |
---|---|
Provider Name | Dr. Sunu Samuel Thomas |
First Address | Boston, MA 02114-2621 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2011 |
Last Update Date | 25/07/2014 |