Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 73111 | MA |
NPI | 1003834490 |
---|---|
Provider Name | Robert Scott Cowan |
First Address | Springfield, MA 01107-1107 |
Second Address | Springfield, MA 01107-1107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 20/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3113540 | (05) | MA |
F56354 | (02) | MD |