Provider Demographics
NPI:1134295751
Name:MOLINA, MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:WEST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02574
Mailing Address - Country:US
Mailing Address - Phone:508-821-7731
Mailing Address - Fax:508-821-4688
Practice Address - Street 1:2007 BAY STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780
Practice Address - Country:US
Practice Address - Phone:508-821-7731
Practice Address - Fax:508-821-4688
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79046207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
130171OtherHARVARD PILGRIM
0701177OtherUNITED HEALTH CARE
403341OtherBLUE CHIP COORDINATED PAR
434260OtherPHCS
7419225684OtherTRICARE CHAMPUS
0081094OtherHEALTH START PROGRAM MA
2291716OtherGROUP AETNA USHC HMO
MA3133885Medicaid
000000026438OtherBMC HEALTHNET PLAN
2188373OtherAETNA USHC HMO
5946A93OtherAETNA USHC NON HMO
J30928OtherBCBS OF MA
079046OtherTUFTS HEALTH PLAN
M17398OtherGROUP BCBS OF MA
20619OtherBCBS OF RI
490630OtherCIGNA HEALTH CARE
130171OtherHARVARD PILGRIM
F97247Medicare UPIN