Doctor Name: | MARY L BAKALOS |
NPI Number: | 1629036090 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 154232 |
Business Practice Address: | 200 Groton Rd Nashoba Valley Medical Center Ayer, MA - 014321168 |
Business Phone Number: | 9787849270 |
Business Fax Number: | |
Mailing Address: | 9 Allan Dr, MAYNARD |
State: | MA |
Postal Code: | 017541909 |
Phone Number: | 9787849270 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 154232 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |