Provider Demographics
NPI:1558681445
Name:MULDER, AMARA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:AMARA
Middle Name:LEE
Last Name:MULDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMARA
Other - Middle Name:LEE
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:143 LONGWATER DR
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1683
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:
Practice Address - Street 1:143 LONGWATER DR
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1683
Practice Address - Country:US
Practice Address - Phone:781-878-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA244807207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042297845OtherUNITED HEALTH CARE
1558681445OtherFALLON
1558681445OtherNEIGHBORHOOD HEALTH PLAN
7200401OtherCIGNA
4168977OtherAETNA
J52096OtherBCBSMA
042297845OtherMULTI-PLAN
MA110097027AMedicaid
AA320520OtherHARVARD PILGRIM
AA320520OtherHARVARD PILGRIM