Gustilo, Mary Catherine
Gustilo, Mary Catherine is an individual health care provider with primary practice located at 541 Main St Suite 301, South Weymouth MA 02190-1868. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gustilo, Mary Catherine can be contacted via phone (781) 952-1480.Contact Information
Primary practice address
541 Main St Suite 301
South Weymouth MA 02190-1868
Phone: (781) 952-1480
Fax: (781) 952-1481
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 160433 | Massachusetts |
Profile Details
| NPI number | 1730175142 |
|---|---|
| LBN Legal business name | Gustilo, Mary Catherine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2005 |
| Last updated | Sep 25th, 2008 - about 16 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 | 1730175142 | NPPES |
| Massachusetts | Other | J21691 | BLUE CROSS |
| Massachusetts | Other | 710668 | BLUE CROSS |
| Massachusetts | MEDICAID | 0107051 | BLUE CROSS |
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