Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 227898 | MA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 227898 | MA |
NPI | 1144255241 |
---|---|
Provider Name | Melissa A Woythaler |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01605-2903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 03/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110082324A | (05) | MA |