Individual
DR. MARIVYL J. LAXER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
827 AMERICAN LEGION HWY, WESTPORT, MA 02790-4128
(508) 636-5101
(508) 636-3651
Mailing address
200 MILL RD, STE 180, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
153456
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110059125A
—
MA
05
—
ML25453
—
RI
Enumeration date
04/20/2006
Last updated
04/22/2020
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