Organization
CARDIOLOGY AND INTERNAL MEDICINE ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J MULLAN MD (PRESIDENT)
(413) 781-1186
Entity
Organization
Contact information
Practice address
222 CAREW ST, SPRINGFIELD, MA 01104-4103
(413) 781-1186
(413) 734-5456
Mailing address
PO BOX 789, LUDLOW, MA 01056-0789
(413) 509-1000
(413) 509-1003
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9787283
—
MA
01
—
M17405
BLUE CROSS GRP
MA
Enumeration date
11/21/2005
Last updated
08/04/2008
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