Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 1338 | MA |
N | 111NR0200X | Radiology | 1338 | MA |
N | 213ER0200X | Radiology | 1338 | MA |
NPI | 1316039399 |
---|---|
Provider Name | Mark A Apazidis |
First Address | West Roxbury, MA 02132-1535 |
Second Address | West Roxbury, MA 02132-1535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U87670 | (02) | MA |