Individual
DR. MARI MINO KENUDSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST WRN 225, PATHOLOGY ASSOCIATES, BOSTON, MA 02114-2696
(617) 726-2967
(617) 726-7474
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
215957
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0181421
—
MA
01
—
215957
TUFTS HEALTH PLAN
MA
01
—
J25460
BCBS MA
MA
Enumeration date
01/09/2006
Last updated
07/08/2007
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