Individual
KATHERINE L PHANEUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
133 LITTLETON RD, SUITE 202, WESTFORD, MA 01886-3115
(978) 577-1946
(978) 692-4716
Mailing address
133 LITTLETON RD, SUITE 202, WESTFORD, MA 01886-3115
(978) 577-1946
(978) 692-4716
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
78728
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078728
TUFTS
MA
05
—
3193497
—
MA
01
—
J30223
BCBS OF MA
MA
Enumeration date
05/04/2006
Last updated
07/23/2010
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