Organization
MARY E SCANNELL MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E SCANNELL MD (PRESIDENT)
(508) 853-6662
Entity
Organization
Contact information
Practice address
140 WEST BOYLSTON DR, WORCESTER, MA 01606-2726
(508) 853-6662
Mailing address
140 WEST BOYLSTON DR, WORCESTER, MA 01606-2726
(508) 853-6662
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017847
NHP GROUP PROVIDER ID
MA
01
—
607331
TUFTS GROUP PAYEE ID
MA
01
—
8510
FALLON VENDOR ID
MA
05
—
9769498
—
MA
01
—
CK8091
RAILROAD MEDICARE GROUP #
MA
01
—
M15675
BC/BS GROUP PROVIDER ID
MA
Enumeration date
10/05/2006
Last updated
04/29/2008
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