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General NPI Number Information
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NPI Number | 1518938109
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Entity Type | Organization
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Legal Business Name | DR MARY P. MEDWAR PC
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 599 MAIN ST
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City | MALDEN
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State | MA
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Zip | 02148-3920
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Country | US
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Telephone | 718-324-2330
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Fax | 781-324-6836
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Provider Business Mailing Address
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Address Line | 599 MAIN ST
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City | MALDEN
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State | MA
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Zip | 02148-3920
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Country | US
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Telephone | 718-324-2330
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Fax | 781-324-6836
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Authorized Official
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Title or Position | DR MARY MEDWAR
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Name | DR. MARY P MEDWAR
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Credential | DC
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Telephone | 781-324-2330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | MA11045
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License Number State | MA
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