Individual
AKI ISHIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
Mailing address
1370 SMITH ST APT 12, NORTH PROVIDENCE, RI 02911-3317
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
1346861531
MA
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
04/29/2020
Last updated
10/20/2020
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