Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 2003-01325 | NC |
NPI | 1033234604 |
---|---|
Provider Name | Dr. Toby A Bates |
First Address | Boston, MA 02109-4806 |
Second Address | Boston, MA 02215-3904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 06/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110076186A | (05) | MA |