Provider Demographics
NPI:1598928525
Name:TAFT, DREW HOWLAND (DPM)
Entity Type:Individual
Prefix:MR
First Name:DREW
Middle Name:HOWLAND
Last Name:TAFT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 UNICORN PARK DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:781-979-0919
Mailing Address - Fax:781-979-0334
Practice Address - Street 1:100 UNICORN PARK DRIVE
Practice Address - Street 2:SUITE 3
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:781-979-0919
Practice Address - Fax:781-979-0334
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1197213ES0103X, 213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001065501Medicare PIN