Individual
DR. MARY EAPEN
Active
Individual
DR. MARY EAPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
42290
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008000315L
HUMANA
—
05
—
1306897210
—
WI
Enumeration date
05/15/2006
Last updated
01/14/2013
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