Individual
LUZBELLA M. SOUTHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14 ROSS AVE, BASEMENT LEFT, MILLIS, MA 02054-1545
(508) 376-0114
(508) 376-9592
Mailing address
14 ROSS AVE, BASEMENT LEFT, MILLIS, MA 02054-1545
(508) 376-0114
(508) 376-9592
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
41938
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0182842
—
MA
01
—
6274
HARVARD PILGRIM HEALTHCAR
MA
01
—
738314
TUFTS HEALTH CARE
MA
Enumeration date
01/09/2007
Last updated
07/09/2007
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