Provider Demographics
NPI:1982687182
Name:MULVEY, THERESE M (MD)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:M
Last Name:MULVEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:STE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:363 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3703
Practice Address - Country:US
Practice Address - Phone:508-679-7234
Practice Address - Fax:508-679-7029
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2013-02-08
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Provider Licenses
StateLicense IDTaxonomies
MA58076207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA058076OtherTUFTS HEALTH CARE
MA3024164Medicaid
MA66032OtherHARVARD PILGRIM
MA0070415OtherAETNA US HEALTH
MAB10116901OtherCIGNA
MAJ06591OtherBLUE CROSS BLUE SHIELD
MA66032OtherHARVARD PILGRIM
MAA66485Medicare UPIN