Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 286821 | MA |
NPI | 1083111769 |
---|---|
Provider Name | Geoffrey Mitchell Guenther |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2018 |
Last Update Date | 15/07/2021 |