Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2010-01800 | NC |
Y | 207X00000X | Orthopaedic Surgeon | 250291 | MA |
NPI | 1033230776 |
---|---|
Provider Name | Thomas J Kesman |
First Address | Worcester, MA 01605-2038 |
Second Address | Worcester, MA 01608-1216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 14/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110093337/A | (05) | MA |
133603100 | (05) | MN |