Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 243528 | MA |
NPI | 1073763090 |
---|---|
Provider Name | Mrs. Cheri Nicole Melsaether Weaver |
First Address | Quincy, MA 02169 |
Second Address | Quincy, MA 02169-1870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2008 |
Last Update Date | 13/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110086534A | (05) | MA |
AA186496 | HARVARD PILGRIM (01) | MA |