Healthcare Provider Details

I. General information

NPI: 1629069810
Provider Name (Legal Business Name): WILLIAM J. MCLAUGHLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 03/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 MILLBURY ST DEPARTMENT OF GYNECOLOGY
AUBURN MA
01501-3205
US

IV. Provider business mailing address

PO BOX 415348
BOSTON MA
02241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 508-721-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number44288
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: