Doctor Name: | MS. MAUREEN W WHITE |
NPI Number: | 1396839130 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 255 |
Business Practice Address: | 2100 Dorchester Ave Dorchester Center, MA - 021245615 |
Business Phone Number: | 6172964000 |
Business Fax Number: | |
Mailing Address: | 166 Lake Shore Dr, WEYMOUTH |
State: | MA |
Postal Code: | 021891537 |
Phone Number: | 7813315543 |
Fax Number: | |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 255 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |