Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 13101 | MA |
N | 204E00000X | Oral & Maxillofacial Surgeon | 13101 | MA |
NPI | 1053300343 |
---|---|
Provider Name | Mr. Howard Seplowitz |
First Address | Stoneham, MA 02180-3317 |
Second Address | Stoneham, MA 02180-3317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T56502 | (02) | |
X04060 | BCBS (01) | MA |