Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 156936 | MA |
NPI | 1215926506 |
---|---|
Provider Name | Robert L Patz |
First Address | Norwood, MA 02062-3441 |
Second Address | Norwood, MA 02062-3441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 11/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171439 | HPHC (01) | MA |
3205797 | (05) | MA |
796968 | TUFTS (01) | MA |
G26189 | (02) | |
J19602 | BCBS (01) | MA |