Provider Demographics
NPI:1164517538
Name:MCGRAVEY, ANN R (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:R
Last Name:MCGRAVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-682-3300
Mailing Address - Fax:978-682-3363
Practice Address - Street 1:12 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-682-3300
Practice Address - Fax:978-682-3363
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA499532080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAD88179Medicare UPIN