Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 10876 | NH |
N | 111NI0900X | Internist | 10876 | NH |
Y | 207RC0000X | Internist - Cardiovascular Disease | 204339 | MA |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 204339 | MA |
NPI | 1184739955 |
---|---|
Provider Name | Peter Ofman |
First Address | Ayer, MA 01432-1124 |
Second Address | Ayer, MA 01432-1124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 10/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30200859 | (05) | NH |