Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2152 | MA |
NPI | 1003992629 |
---|---|
Provider Name | Erin Mackey |
First Address | Westford, MA 01886-6326 |
Second Address | Beverly, MA 01915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 20/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9702652 | (05) | MA |
M11709 | (02) | MA |