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Individual

INGER-MARIE R PU

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
133 ORNAC, CONCORD, MA 01742
(978) 369-1400
(978) 287-3680
Mailing address
133 ORNAC, CONCORD, MA 01742
(978) 369-1400
(978) 287-3680

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
78784
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206546
HARVARD PILGRIM HLTH PLAN
01
25876
FALLON
MA
01
737748
TUFTS HLTH PLAN
01
J30901
BCBS MA
MA
Enumeration date
05/23/2006
Last updated
07/08/2007
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