Individual
DR. MANORAMA MATHUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1127 SALEM ST, MALDEN, MA 02148-4637
(781) 324-6192
(781) 324-2930
Mailing address
1127 SALEM ST, MALDEN, MA 02148-4637
(781) 324-6192
(781) 324-2930
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
37384
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2021544
—
MA
01
—
M08791B
MEDICARE PTAN
MA
Enumeration date
11/14/2005
Last updated
01/05/2016
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