Provider Demographics
NPI:1295835494
Name:DR. MAURA MCGRANE MD. PC.
Entity Type:Organization
Organization Name:DR. MAURA MCGRANE MD. PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:MCGRANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-922-9778
Mailing Address - Street 1:83 HERRICK ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915
Mailing Address - Country:US
Mailing Address - Phone:978-922-9778
Mailing Address - Fax:978-922-3878
Practice Address - Street 1:83 HERRICK ST
Practice Address - Street 2:SUITE2001
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-922-9778
Practice Address - Fax:978-922-3878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3142990Medicaid
MA3142990Medicaid
MAA20312Medicare ID - Type UnspecifiedGROUP