MEDICARE: CAROLINE MAWANDA PC

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1861365793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINE MAWANDA PC

Provider Business Mailing Address
First Line	:	121 BRICK KILN RD STE 216
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-3259
Country	:	US
Telephone Number	:	617-938-9038
Fax Number	:	617-398-4942

Provider Business Practice Location Address
First Line	:	121 BRICK KILN RD STE 216
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-3259
Country	:	US
Telephone Number	:	617-938-9038
Fax Number	:	617-398-4942

Authorized Official
Title or Position	:	OWNER
Name	:	CAROLINE N MAWANDA
Credential	:	NP
Telephone Number	:	617-938-9038

Provider Enumeration Date	:	09/26/2025
Last Update Date	:	03/13/2026

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