Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 59277 | MA |
NPI | 1053312397 |
---|---|
Provider Name | Ronald C Hartfelder |
First Address | Worcester, MA 01608-1604 |
Second Address | Salem, MA 01970-2100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 14/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3038025 | (05) | MA |
A66629 | (02) |