Fagan, Maura A
Fagan, Maura A is an individual health care provider with primary practice located at 725 Albany Street Shaprio 9, Suite B, Boston MA 02118-2526. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is her primary health care specialty. Fagan, Maura A can be contacted via phone (617) 414-4290.Contact Information
Primary practice address
725 Albany Street Shaprio 9, Suite B
Boston MA 02118-2526
Phone: (617) 414-4290
Fax: (617) 414-4285
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 72161 | Massachusetts |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 72161 | Massachusetts |
Profile Details
| NPI number | 1073638995 |
|---|---|
| LBN Legal business name | Fagan, Maura A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2007 |
| Last updated | May 12th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073638995 | NPPES |
| Massachusetts | MEDICAID | 110053951A |
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