Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 211721 | MA |
NPI | 1609861418 |
---|---|
Provider Name | Karl Benjamin Coyner |
First Address | Boston, MA 02115-6110 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 15/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0182320 | (05) | MA |
211721 | TUFTS HEALTH CARE (01) | MA |
H71166 | (02) | MA |
H71166 | HARVARD PILGRIM HEALTH (01) | MA |
J25709 | BLUE CROSS/BLUE SHIELD (01) | MA |