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General NPI Number Information
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NPI Number | 1366403149
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Entity Type | Individual
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Provider Name | MARY ATHENA WARNER MD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 75 FRANCIS STREET RADIOLOGY BRIGHAM & WOMEN'S HOSPITAL
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City | BOSTON
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State | MA
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Zip | 02115
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Country | US
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Telephone | 617-732-6280
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Fax |
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Provider Business Mailing Address
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Address Line | 75 FRANCIS STREET RADIOLOGY BRIGHAM & WOMEN'S HOSPITAL
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City | BOSTON
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State | MA
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Zip | 02115
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Country | US
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Telephone | 617-732-6280
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 226890
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 011971
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 226890
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 011971
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License Number State | ME
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