Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 49080 | MA |
N | 111NI0900X | Internist | 49080 | MA |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 49080 | MA |
NPI | 1023017373 |
---|---|
Provider Name | Richard A Haas |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01655-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110005417A | (05) | MA |
D94194 | (02) |