Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 042.0012768 | VT |
Y | 204F00000X | Transplant Surgeon | 208430 | MA |
N | 208200000X | Surgeon | 208430 | MA |
N | 208600000X | Surgeon | 208430 | MA |
NPI | 1285656314 |
---|---|
Provider Name | Dr. Tatsuo Kawai |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 24/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0153851 | (05) | MA |
208430 | TUFTS HEALTH PLAN (01) | MA |
H50156 | (02) | |
J24185 | BCBS MA (01) | MA |