Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 16890 | MA |
Y | 213EG0000X | General Practice | 16890 | MA |
NPI | 1003026030 |
---|---|
Provider Name | Stephen M Lorkiewicz |
First Address | Webster, MA 01570-1418 |
Second Address | Webster, MA 01570-1418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |