Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 77536 | MA |
NPI | 1003876707 |
---|---|
Provider Name | John Mclaulin |
First Address | Arlington, MA 02474-6623 |
Second Address | Newburyport, MA 01950-3867 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2006 |
Last Update Date | 24/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3112543 | (05) | MA |
E39837 | (02) | MA |
J30102 | BLUE SHIELD (01) | MA |