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1881654135

NPI Code Detail

MEDICARE: MARY G PEARSON DO

MEDICARE: MARY G PEARSON DO

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	207Q00000X	Family Medicine Physician	9106	NH
2	207Q00000X	Family Medicine Physician	76376	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	723885	OTHER	MA	TUFTS HEALTH PLAN
3	4480241	OTHER	NH	AETNA PPO
4	0402142YPNH01	OTHER	NH	BCBS NH
5	3084720	OTHER	NH	AETNA HMO
6	15221	OTHER	NH	CIGNA NH
7	B10383301	OTHER	MA	CIGNA MASSACHUSETTS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	F30970	OTHER	MA	HARVARD PILGRIM
10	J12643	OTHER	MA	BCBS MA

General Provider Information

NPI Number	:	1881654135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY G PEARSON DO

Provider Business Mailing Address
First Line	:	80 ROUTE 125
Second Line	:
City	:	KINGSTON
State	:	NH
Zip	:	03848-3535
Country	:	US
Telephone Number	:	603-642-6700
Fax Number	:	603-642-6701

Provider Business Practice Location Address
First Line	:	80 ROUTE 125
Second Line	:
City	:	KINGSTON
State	:	NH
Zip	:	03848-3535
Country	:	US
Telephone Number	:	603-642-6700
Fax Number	:	603-642-6701

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	03/05/2009

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Directions to “ MARY G PEARSON DO” Practice Location

Language	Start Address	Practice Location

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