Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 2929 | MA |
NPI | 1841785623 |
---|---|
Provider Name | Michael Stephen Dion |
First Address | Hadley, MA 01035-9428 |
Second Address | South Hadley, MA 01075-1423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2018 |
Last Update Date | 25/06/2018 |