MEDICARE: KATHERINE MARY MERRA MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	74730	MA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	719345	OTHER		TUFTS MEDICARE PREFERRED

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0016866	OTHER	NHP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	719345	OTHER	TUFTS HEALTH PLAN
5	042297845	OTHER	HCVM/FIRST HEATLH/COVENTY
6	900324	OTHER	UNITED HEALTH CARE
7	J11386	OTHER	BLUE SHIELD
8	042297845	OTHER	TRICARE
9	042297845	OTHER	PHCS/MULTI-PLAN
10	B20458702	OTHER	CIGNA HEALTH CARE
11	000233	OTHER	ONE HEALTH
12	042297845	OTHER	GREAT WEST HEALTH CARE
13	80314	OTHER	GIC/UNICARE
14	53309	OTHER	FALLON
15	171346	OTHER	HARVARD PILGRIM HEALTH
16	3681368	OTHER	AETNA

NPI Number	:	1336140425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE MARY MERRA MD

Provider Business Mailing Address
First Line	:	2 POND PARK RD.
Second Line	:	STE. 102
City	:	HINGHAM
State	:	MA
Zip	:	02043-4309
Country	:	US
Telephone Number	:	781-337-5555
Fax Number	:	781-331-0300

Provider Business Practice Location Address
First Line	:	2 POND PARK RD.
Second Line	:	STE. 102
City	:	HINGHAM
State	:	MA
Zip	:	02043-4309
Country	:	US
Telephone Number	:	781-337-5555
Fax Number	:	781-331-0300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	10/13/2011