Individual
KATHLEEN I MCCULLOUGH
Active
Individual
KATHLEEN I MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
79413
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015272
NEIGHBORHOOD HEALTH PLAN
MA
01
—
045698
TUFTS HEALTH PLAN
MA
05
—
6173497
—
MA
01
—
7592074-002
CIGNA
MA
01
—
J02837
BLUE CROSS
MA
01
—
PV338
HARVARD PILGRIM
MA
Enumeration date
08/04/2006
Last updated
05/31/2011
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