Individual
DR. MAUREEN T KAVANAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
830 HARRISON AVE, MOAKLEY SUITE 1200, BOSTON, MA 02118-2905
(617) 638-8655
(617) 638-8653
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
44436
MA
2086X0206X
Surgical Oncology Physician
Primary
44436
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110003694A
—
MA
Enumeration date
03/20/2006
Last updated
06/30/2014
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