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Individual

MARK C. ZULLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
70 KENYON AVE, SUITE 211, WAKEFIELD, RI 02879-4239
(401) 789-8543
(401) 782-8766
Mailing address
70 KENYON AVE, SUITE 211, WAKEFIELD, RI 02879-4239
(401) 789-8543
(401) 782-8766

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
06480
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000028143
BMC HEALTHNET
MA
01
0101102
UHC
01
052518
TUFTS
MA
05
3043355
MA
01
35998
FALLON
MA
01
400988
RI BLUE CHIP
01
710716
HPHC
MA
01
B10350101
CIGNA
MA
01
J11769
MABC
MA
Enumeration date
08/11/2006
Last updated
04/01/2015
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