Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 234873 | MA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 234873 | MA |
NPI | 1265605174 |
---|---|
Provider Name | Mary A Vadnais |
First Address | Boston, MA 02215 |
Second Address | Boston, MA 02215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 07/01/2021 |