Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 281426 | MA |
N | 208000000X | Pediatrician | 4301097950 | MI |
N | 208000000X | Pediatrician | MD431964 | PA |
Y | 2080P0210X | Pediatric Nephrologist | 281426 | MA |
N | 2080P0210X | Pediatric Nephrologist | 4301097950 | MI |
NPI | 1558551283 |
---|---|
Provider Name | Matthew G Sampson |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 14/10/2019 |