Individual
BETH KURTZ MAZYCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
326 NICHOLS RD, FITCHBURG, MA 01420-1914
(978) 343-5270
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
152229
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1319833
—
MA
01
—
221845
UGS
MA
01
—
J17376
BLUE SHIELD OF MA
MA
Enumeration date
03/23/2006
Last updated
11/16/2020
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