Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 51182 | MA |
NPI | 1083675565 |
---|---|
Provider Name | John I Reed |
First Address | Worcester, MA 01606-2714 |
Second Address | Worcester, MA 01606-2714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2006 |
Last Update Date | 27/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3037380 | (05) | MA |