Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 32680 | MA |
NPI | 1013282821 |
---|---|
Provider Name | Dr. William Boaz Stason |
First Address | Lincoln, MA 01773-2006 |
Second Address | Lincoln, MA 01773-2006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2012 |
Last Update Date | 12/03/2012 |