Provider Demographics
NPI:1720216856
Name:HURST, MARGARET M (DO)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:M
Last Name:HURST
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:M
Other - Last Name:PROVOST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:125 BOUNDARY DRIVE
Mailing Address - Street 2:
Mailing Address - City:LUTES MOUNTAIN
Mailing Address - State:NEW BRUNSWICK
Mailing Address - Zip Code:E1G 5C6
Mailing Address - Country:CA
Mailing Address - Phone:506-382-7570
Mailing Address - Fax:506-857-3896
Practice Address - Street 1:125 BOUNDARY DRIVE
Practice Address - Street 2:
Practice Address - City:LUTES MOUNTAIN
Practice Address - State:NEW BRUNSWICK
Practice Address - Zip Code:E1G 5C6
Practice Address - Country:CA
Practice Address - Phone:506-382-7570
Practice Address - Fax:506-857-3896
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-27
Last Update Date:2009-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1733208000000X
NC9801309208000000X
SC0481208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics