Individual
MADELEINE MBUYAMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
63 MAIN ST, BROCKTON, MA 02301-4012
(508) 559-6699
(508) 583-4649
Mailing address
63 MAIN ST, BROCKTON, MA 02301-4342
(508) 559-1567
(508) 559-5073
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
159479
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000036884
BMC HEALTHNET
MA
01
—
0017976
NEIGHBORHOOD HEALTH PLAN
—
01
—
32530
HEALTHY START
—
01
—
98634901
NETWORK HEALTH
MA
01
—
J25606
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/11/2006
Last updated
05/21/2008
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