Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | D52121 | MD |
N | 111NI0900X | Internist | D52121 | MD |
Y | 207RR0500X | Rheumatology | 231034 | MA |
NPI | 1053346924 |
---|---|
Provider Name | John Stone |
First Address | Boston, MA 02114 |
Second Address | Boston, MA 02114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 13/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
125061200 | (05) | MD |
F59248 | (02) | MD |