Healthcare Provider Details

I. General information

NPI: 1699709451
Provider Name (Legal Business Name): TERESA A VAN BUREN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

METRO WEST MEDICAL CTR. - CANCER CARE CT 99 LINCOLN STREET
FRAMINGHAM MA
01701
US

IV. Provider business mailing address

99 LINCOLN ST
FRAMINGHAM MA
01702-6327
US

V. Phone/Fax

Practice location:
  • Phone: 508-383-1260
  • Fax:
Mailing address:
  • Phone: 508-383-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number79399
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: