MEDICARE: MRS. CINDY MUNRO POPOVIC APRN

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
1	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	002532	CT
2	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	RN208893	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0705608	OTHER	MA	MASSHEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427059021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CINDY MUNRO POPOVIC APRN

Provider Business Mailing Address
First Line	:	9 INDUSTRIAL RD
Second Line	:	STE 5
City	:	MILFORD
State	:	MA
Zip	:	01757-3736
Country	:	US
Telephone Number	:	508-553-3583
Fax Number	:	508-634-7315

Provider Business Practice Location Address
First Line	:	100 MEDWAY RD
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-2923
Country	:	US
Telephone Number	:	508-634-7338
Fax Number	:	508-634-7315

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	11/02/2018

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