Individual
TIMOTHY J LEPORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
57 PROSPECT ST, NANTUCKET, MA 02554-2799
(508) 228-9053
Mailing address
57 PROSPECT ST, NANTUCKET, MA 02554-2799
(508) 228-9053
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12345
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2049325
—
MA
Enumeration date
04/08/2006
Last updated
07/08/2007
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