Individual
DR. MARY LISA MCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
97 LIBBEY INDUSTRIAL PKWY STE 100, EAST WEYMOUTH, MA 02189-3110
(781) 331-3300
(781) 337-8356
Mailing address
97 LIBBEY INDUSTRIAL PKWY STE 100, EAST WEYMOUTH, MA 02189-3110
(781) 331-3300
(781) 337-8356
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
77904
MA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
77904
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110053096A
—
MA
01
—
J13871
MEDICARE
MA
Enumeration date
05/28/2006
Last updated
12/23/2021
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