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Individual

PAULA M MUTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
100 AMESBURY ST, SUITE 113, LAWRENCE, MA 01840
(978) 685-5474
(978) 689-0493
Mailing address
198 MASSACHUSSETTS AVENUE, SUITE 100, NORTH ANDOVER, MA 01845
(978) 685-5474
(788) 820-2369

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
81002
MA
2086S0129X
Vascular Surgery Physician
81002
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3152464
MA
Enumeration date
07/13/2005
Last updated
07/03/2019
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