Individual
KATHY THEALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 WASHINGTON ST # 245, DEPARTMENT OF HEMATOLOGY/ ONCOLOGY, BOSTON, MA 02111-1552
(617) 636-8148
(617) 636-8538
Mailing address
800 WASHINGTON ST # 245, DEPARTMENT OF HEMATOLOGY/ ONCOLOGY, BOSTON, MA 02111-1552
(617) 636-8148
(617) 636-8538
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
MD10105
RI
207RX0202X
Medical Oncology Physician
Primary
81285
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2127091
—
MA
05
—
9002761
—
RI
Enumeration date
12/07/2005
Last updated
11/05/2009
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