Healthcare Provider Details

I. General information

NPI: 1215565643
Provider Name (Legal Business Name): MARGARET LEIGH INNERS HART MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 01/07/2024
Certification Date: 01/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 MONTVALE AVE STE 4100
STONEHAM MA
02180-3636
US

IV. Provider business mailing address

92 MONTVALE AVE STE 4100
STONEHAM MA
02180-3636
US

V. Phone/Fax

Practice location:
  • Phone: 781-832-2530
  • Fax:
Mailing address:
  • Phone: 781-832-2530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1014041
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: