Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 47715 | MA |
N | 111NI0900X | Internist | 47715 | MA |
Y | 207RA0201X | Internist - Allergy & Immunology | 47715 | MA |
N | 207RA0201X | Internist - Allergy & Immunology | MD038893 | DC |
N | 207RR0500X | Rheumatology | 47715 | MA |
N | 207RR0500X | Rheumatology | MD038893 | DC |
NPI | 1649251778 |
---|---|
Provider Name | Lawrence M. Dubuske |
First Address | Gardner, MA 01440-3926 |
Second Address | Washington, DC 20037-2704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 07/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0152749 | (05) | MA |
A66516 | (02) |