Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MA37467 | MA |
NPI | 1023078920 |
---|---|
Provider Name | Mr. Alfred G Krebs |
First Address | Plymouth, MA 02360-2642 |
Second Address | Plymouth, MA 02360-2642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2041596 | (05) | MA |
A59406 | (02) |