Individual
MIA D GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MCLEAN HOSPITAL, MS 222, 115 MILL STREET, BELMONT, MA 02478
(617) 855-3070
Mailing address
MCLEAN HOSPITAL, MS 222, 115 MILL STREET, BELMONT, MA 02478
(617) 855-3070
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
234932
MA
2084P0800X
Psychiatry Physician
L-228279
MA
Other
Enumeration date
02/27/2007
Last updated
06/02/2011
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