Individual
MARY CATHERINE GUSTILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
541 MAIN ST, SUITE 301, SOUTH WEYMOUTH, MA 02190-1868
(781) 952-1480
(781) 952-1481
Mailing address
541 MAIN ST, SUITE 301, SOUTH WEYMOUTH, MA 02190-1868
(781) 952-1480
(781) 952-1481
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
160433
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107051
—
MA
01
—
710668
HARVARD PILGRIM
MA
01
—
J21691
BLUE CROSS
MA
Enumeration date
09/21/2005
Last updated
09/25/2008
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