Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 82166 | MA |
NPI | 1558471292 |
---|---|
Provider Name | Shimon Segal |
First Address | Brookline, MA 02445-7117 |
Second Address | Wellesley Hills, MA 02481-2137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3158314 | (05) | MA |
DB320A | MEDICARE OF FL (01) | FL |
G28197 | (02) | MA |