Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 261498 | MA |
NPI | 1629193214 |
---|---|
Provider Name | Dr. William David Recupero |
First Address | Dartmouth, MA 02747-1242 |
Second Address | Dartmouth, MA 02747-1242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 22/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110102366A | (05) | MA |