Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 157915 | MA |
Y | 207RI0011X | Interventional Cardiology | 157915 | MA |
NPI | 1033176466 |
---|---|
Provider Name | Jeffrey Popma |
First Address | Boston, MA 02215-5324 |
Second Address | Boston, MA 02215-5324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 01/02/2016 |