Provider Demographics
NPI:1720183908
Name:MATHUR, USHA (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:
Last Name:MATHUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SUNFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-2862
Mailing Address - Country:US
Mailing Address - Phone:508-842-3735
Mailing Address - Fax:508-363-1512
Practice Address - Street 1:30 EDWARD ST
Practice Address - Street 2:WORCESTER
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2946
Practice Address - Country:US
Practice Address - Phone:508-368-3539
Practice Address - Fax:508-363-1512
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA483662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA66250Medicare UPIN