# MARY E SCANNELL MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568558930
- **Authorized official:** MARY E SCANNELL MD (PRESIDENT)
- **Authorized official phone:** (508) 853-6662

## Contact information

- **Practice address:** 140 WEST BOYLSTON DR, WORCESTER, MA 01606-2726
- **Practice address phone:** (508) 853-6662
- **Mailing address:** 140 WEST BOYLSTON DR, WORCESTER, MA 01606-2726
- **Mailing address phone:** (508) 853-6662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 04/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0017847 | NHP GROUP PROVIDER ID | MA |
| 01 | — | 607331 | TUFTS GROUP PAYEE ID | MA |
| 01 | — | 8510 | FALLON VENDOR ID | MA |
| 05 | — | 9769498 | — | MA |
| 01 | — | CK8091 | RAILROAD MEDICARE GROUP \# | MA |
| 01 | — | M15675 | BC/BS GROUP PROVIDER ID | MA |