Provider Demographics
NPI:1346230026
Name:MCNAUGHTON-COLLINS, MARY F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:MCNAUGHTON-COLLINS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-8157
Mailing Address - Fax:617-724-7799
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:INTERNAL MEDICINE ASSOCIATES TEAM 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-8157
Practice Address - Fax:617-724-7799
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2012-07-25
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Provider Licenses
StateLicense IDTaxonomies
MA77630207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ17573OtherBCBS MA
MAD77630OtherTUFTS HEALTH PLAN
MA3165779Medicaid
MAJ17573OtherBCBS MA
MAA22669Medicare ID - Type Unspecified