Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 237365 | MA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 237365 | MA |
NPI | 1093962334 |
---|---|
Provider Name | Marshal T Fox |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 02/02/2018 |