Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 251044 | MA |
NPI | 1013177534 |
---|---|
Provider Name | Michael Douglas Baratz |
First Address | Boston, MA 02111-1552 |
Second Address | Boston, MA 02111-1552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 30/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1101000019A | (05) | MA |
5922834 | (05) | NC |
NC1798 | (05) | SC |
S400215512 | MEDICARE (01) | MA |