Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 254534 | MA |
NPI | 1003044314 |
---|---|
Provider Name | Sheela S Maru |
First Address | Boston, MA 02118-2371 |
Second Address | Boston, MA 02118-4001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 11/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110094020A | (05) | MA |