Individual
MARY DAWN T CO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
119 BELMONT ST, WORCESTER, MA 01605-2903
(774) 441-8230
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
206858
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110004064A
—
MA
Enumeration date
11/16/2005
Last updated
04/01/2025
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