Provider Demographics
NPI:1831141688
Name:OGRADY, KATHLEEN M (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:OGRADY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5 NEPONSET ST FL STREET2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-368-5532
Mailing Address - Fax:508-595-2021
Practice Address - Street 1:378 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-2673
Practice Address - Country:US
Practice Address - Phone:508-595-2513
Practice Address - Fax:508-595-2021
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2019-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA52475207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherONE HEALTH PLAN
9900827OtherFALLON COMM HEALTH PLAN
J03040OtherBLUE CARE ELECT
5848197OtherAETNA
784169OtherMVP HEALTH CARE
0404469OtherEVERCARE
110244780OtherRAILROAD MEDICARE
AA1239OtherHARVARD PILGRIM HLTHCARE
J03040OtherMEDICARE B
J03040OtherBLUE SHIELD HMO BLUE
6566284OtherCIGNA HEALTH PLAN
MA6175082Medicaid
5848197OtherUS HEALTHCARE
042472266OtherTHREE RIVERS
6175082OtherMEDICAID WELFARE
0122971OtherMEDICAID PCC
042472266OtherPRIVATE HEALTHCARE SYSTEM
J03040OtherBLUE SHIELD INDEMNITY
042472266OtherONE HEALTH PLAN
5848197OtherAETNA