Provider Demographics
NPI:1356303754
Name:COUTINHO, BRENDA G (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:G
Last Name:COUTINHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9 INDUSTRIAL RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3735
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:508-473-1210
Practice Address - Street 1:221 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2825
Practice Address - Country:US
Practice Address - Phone:508-482-5405
Practice Address - Fax:508-482-5407
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA158083207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA120570Medicaid
MAH14953Medicare UPIN
MA120570Medicaid