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NPI Code Detail

MEDICARE: DR. MARY JOANNA MCINTYRE M.D.

MEDICARE:  DR. MARY JOANNA MCINTYRE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician82783OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053301424
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY JOANNA MCINTYRE M.D.
Provider Business Mailing Address
First Line : 900 COTTAGE GROVE RD
Second Line :
City : BLOOMFIELD
State : CT
Zip : 06002-2920
Country : US
Telephone Number : 800-400-6354
Fax Number :
Provider Business Practice Location Address
First Line : 900 COTTAGE GROVE RD
Second Line :
City : BLOOMFIELD
State : CT
Zip : 06002-2920
Country : US
Telephone Number : 800-400-6354
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 04/16/2026

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