Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 36769 | MA |
NPI | 1164502472 |
---|---|
Provider Name | Dr. Wayne William Karolow |
First Address | Danvers, MA 01923 |
Second Address | Lawrence, MA 01842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2066009 | (05) | MA |
A35201 | (02) |