Individual
DR. MARYETTA E. KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 FRUIT STREET, YAWKEY 5-062 MASSACHUSETTS GENERAL HOSPITAL, BOSTON, MA 02114-2696
(617) 726-3826
(617) 643-1639
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
38249
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6171613
—
MA
01
—
724773
TUFTS HEALTH PLAN
MA
01
—
B11517
BCBS MA
MA
Enumeration date
10/25/2005
Last updated
09/02/2009
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