Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 75799 | MA |
N | 207RX0202X | Medical Oncology | 75799 | MA |
NPI | 1366468415 |
---|---|
Provider Name | Michael Constantine |
First Address | Franklin, MA 02038-3156 |
Second Address | Milford, MA 01757-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3138984 | (05) | MA |
G03929 | (02) |