Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 49352 | MA |
NPI | 1023092327 |
---|---|
Provider Name | Katherine S Upchurch |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01605-2964 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 18/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3054381 | (05) | MA |
D82884 | (02) | MA |