MEDICARE: CAROLYN E FOX CNM

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	176B00000X	Midwife	227782	MA

General Provider Information

NPI Number	:	1528248093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN E FOX CNM

Provider Business Mailing Address
First Line	:	85 E CONCORD ST
Second Line	:	6TH FLOOR
City	:	BOSTON
State	:	MA
Zip	:	02118-2335
Country	:	US
Telephone Number	:	617-414-5469
Fax Number	:	617-414-7300

Provider Business Practice Location Address
First Line	:	85 E CONCORD ST
Second Line	:	6TH FLOOR
City	:	BOSTON
State	:	MA
Zip	:	02118-2335
Country	:	US
Telephone Number	:	617-414-5469
Fax Number	:	617-414-7300

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

Provider Enumeration Date	:	11/13/2007
Last Update Date	:	11/13/2007

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