Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 72980 | MA |
NPI | 1063493302 |
---|---|
Provider Name | Susan E Donohue |
First Address | Boston, MA 02241-5348 |
Second Address | Marlborough, MA 01752-1228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2005 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110049618A | (05) | MA |
E77305 | (02) | MA |