Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 283771 | MA |
Y | 208600000X | Surgeon | 283771 | MA |
NPI | 1003298753 |
---|---|
Provider Name | Matthew C Rade |
First Address | Boston, MA 02241-5348 |
Second Address | Milford, MA 01757-3039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2015 |
Last Update Date | 29/06/2021 |