Provider Demographics
NPI:1538144571
Name:FRATES, MARY CATHERINE (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:FRATES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:RADIOLOGY BRIGHAMT WOMENS HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-6280
Mailing Address - Fax:617-525-7333
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:RADIOLOGY BRIGHAMT WOMENS HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-6280
Practice Address - Fax:617-525-7333
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2012-08-09
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Provider Licenses
StateLicense IDTaxonomies
MA713652085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA071365OtherTUFTS HEALTH CARE
MA3072711Medicaid
MAJ10843OtherBLUE CROSS BLUE SHIELD
MAJ10843OtherBLUE CROSS BLUE SHIELD
MAJ10843Medicare ID - Type Unspecified