Provider Demographics
NPI:1598905226
Name:STANFORD, FATIMA CODY (MD, MPH)
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:CODY
Last Name:STANFORD
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Gender:F
Credentials:MD, MPH
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:50 STANIFORD ST STE 430
Mailing Address - Street 2:MGH WEIGHT CENTER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2541
Mailing Address - Country:US
Mailing Address - Phone:617-726-4400
Mailing Address - Fax:617-724-6565
Practice Address - Street 1:50 STANIFORD ST STE 430
Practice Address - Street 2:MGH WEIGHT CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2541
Practice Address - Country:US
Practice Address - Phone:617-726-4400
Practice Address - Fax:617-724-6565
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2015-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA246887207R00000X, 208000000X, 207RG0100X
MA257385207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine