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Individual

MYRA CUMMINGS MABRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.,

Contact information

Practice address
9 SASSAFRAS MEW, LAKE ARIEL, PA 18436-3252
(570) 689-2132
(866) 592-5338
Mailing address
9 SASSAFRAS MEW, LAKE ARIEL, PA 18436-3252
(570) 689-2132
(866) 592-5338

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2010-01247
NC
207V00000X
Obstetrics & Gynecology Physician
241003-1
NY
207VX0000X
Obstetrics Physician
Primary
MB86253
NJ

Other

Enumeration date
05/13/2009
Last updated
10/01/2013
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