Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 220574 | MA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 220574 | MA |
NPI | 1093805806 |
---|---|
Provider Name | Lawrence M Specht |
First Address | Burlington, MA 01805-0001 |
Second Address | Burlington, MA 01805-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 16/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110037749A | (05) | MA |
H64290 | (02) | MA |