Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 34120 | MA |
NPI | 1043287113 |
---|---|
Provider Name | Dr. Terry P Hadley |
First Address | Concord, MA 01742-2189 |
Second Address | Concord, MA 01742-2189 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 24/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2026155 | (05) | MA |
A34241 | (02) | MA |