Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 52701 | MA |
N | 207Q00000X | Family Doctor | 52701 | MA |
NPI | 1003985813 |
---|---|
Provider Name | Thomas Hagamen |
First Address | Springfield, MA 01199-1000 |
Second Address | Greenfield, MA 01301-2613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 08/07/2007 |