Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 18315 | MA |
NPI | 1518033729 |
---|---|
Provider Name | John P Ouano |
First Address | Northborough, MA 01532-1662 |
Second Address | Northborough, MA 01532-1662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018315 | TUFTS (01) | MA |
16623 | HARVARD PILGRIM (01) | MA |
65505 | FALLON (01) | MA |
BLUE CROSS | OUX20085 (01) | MA |
U90719 | (02) | MA |