Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN2294926 | MA |
NPI | 1083196992 |
---|---|
Provider Name | Mr. Michael Collins Horvath |
First Address | Middleton, MA 01949-1526 |
Second Address | Middleton, MA 01949-1526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2018 |
Last Update Date | 06/09/2018 |