Provider Demographics
NPI:1902191893
Name:PETERS, MARY LINTON B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY LINTON
Middle Name:B
Last Name:PETERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY LINTON
Other - Middle Name:B
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:SHAPIRO 913
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-2100
Mailing Address - Fax:617-975-5665
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:SHAPIRO 913
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-2100
Practice Address - Fax:617-975-5665
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA258698207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology