Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 214020 | MA |
Y | 208000000X | Pediatrician | 214020 | MA |
NPI | 1023007184 |
---|---|
Provider Name | Dr. Marsha Kay Fearing |
First Address | Southbridge, MA 01550-0040 |
Second Address | Southbridge, MA 01550-4051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 07/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0182931 | (05) | MA |
214020 | TUFTS HEALTH PLAN (01) | MA |
I33519 | (02) | |
J25574 | BCBS OF MA (01) | MA |