Individual
ROGER POTTANAT
Active
Individual
ROGER POTTANAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
245867
MA
2084P0804X
Child & Adolescent Psychiatry Physician
245867
MA
Other
Enumeration date
06/18/2010
Last updated
04/05/2012
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