Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 219725 | MA |
NPI | 1285666719 |
---|---|
Provider Name | Frank P Fechner |
First Address | Worcester, MA 01604-1661 |
Second Address | Worcester, MA 01604-1661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 25/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A37782 | (02) | MA |