Individual
DR. MARYAM YEGANEGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
63 MAIN ST, BROCKTON, MA 02301
(508) 559-6699
Mailing address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
278197
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2015
Last updated
05/21/2019
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