Healthcare Provider Details

I. General information

NPI: 1891759643
Provider Name (Legal Business Name): LINDA COVELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 01/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 MOUNT AUBURN ST MOUNT AUBURN HOSPITAL
CAMBRIDGE MA
02138-5502
US

IV. Provider business mailing address

330 MOUNT AUBURN ST MOUNT AUBURN HOSPITAL
CAMBRIDGE MA
02138-5502
US

V. Phone/Fax

Practice location:
  • Phone: 617-499-5064
  • Fax: 617-499-5492
Mailing address:
  • Phone: 617-499-5064
  • Fax: 617-499-5492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number37531
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: