MEDICARE: DR. MARY L. DELANEY MD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	71454	MA
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	71454	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J12527	OTHER	MA	BLUE CROSS BLUE SHIELD
2	0036416	OTHER	MA	NEIGHBORHOOD HEALTHPLAN
3	1280731	OTHER	MA	FALLON COMMUNITY HEALTH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	071454	OTHER	MA	TUFTS HEALTH PLAN
6	60661	OTHER	MA	HARVARD PILGRIM

General Provider Information

NPI Number	:	1336149228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY L. DELANEY MD

Provider Business Mailing Address
First Line	:	541 MAIN ST
Second Line	:	SUITE 210
City	:	SOUTH WEYMOUTH
State	:	MA
Zip	:	02190-1868
Country	:	US
Telephone Number	:	781-952-1280
Fax Number	:	781-952-1570

Provider Business Practice Location Address
First Line	:	541 MAIN ST
Second Line	:	SUITE 210
City	:	SOUTH WEYMOUTH
State	:	MA
Zip	:	02190-1868
Country	:	US
Telephone Number	:	781-952-1280
Fax Number	:	781-952-1570

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	03/13/2014

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