Healthcare Provider Details

I. General information

NPI: 1942596408
Provider Name (Legal Business Name): KARA TWEADEY BOS M.D., M.P.H
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 CORPORATE DR STE 300
PORTSMOUTH NH
03801-2847
US

IV. Provider business mailing address

PO BOX 412503
BOSTON MA
02241-2503
US

V. Phone/Fax

Practice location:
  • Phone: 603-610-8079
  • Fax:
Mailing address:
  • Phone: 617-726-3884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25081
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number125059936
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number68219-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: