Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 159775 | MA |
NPI | 1013039601 |
---|---|
Provider Name | Michael Joseph Landman |
First Address | Lawrence, MA 01841-2310 |
Second Address | Lawrence, MA 01841-2310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 16/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3196852 | (05) | MA |
G92911 | (02) |