Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 45717 | MA |
NPI | 1083870240 |
---|---|
Provider Name | Phyllis Spieler |
First Address | Andover, MA 01810-1509 |
Second Address | Andover, MA 01810-1509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 06/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0110213 | (05) | MA |
D82806 | (02) | MA |