Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | LP02156 | RI |
N | 111NI0900X | Internist | LP02156 | RI |
Y | 207RI0200X | Infectious Disease | 253-632 | MA |
N | 207RI0200X | Infectious Disease | M-1975 | GU |
NPI | 1083902464 |
---|---|
Provider Name | Michele Yamamoto |
First Address | Worcester, MA 01655-0002 |
Second Address | Worcester, MA 01655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2011 |
Last Update Date | 01/08/2016 |