Provider Demographics
NPI:1881694362
Name:NORRIS, MARY E (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:NORRIS
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 1:2 HOSPITAL DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-6632
Mailing Address - Country:US
Mailing Address - Phone:413-540-5048
Mailing Address - Fax:413-540-5049
Practice Address - Street 1:2 HOSPITAL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6632
Practice Address - Country:US
Practice Address - Phone:413-540-5048
Practice Address - Fax:413-540-5049
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18549207RG0100X
WAMD00045945207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA207359OtherL & I
WA8941018OtherCRIME VICTIMS
WA8448490Medicaid
OR028101Medicaid
MS03088021Medicaid
MS03088021Medicaid
MSC64787Medicare UPIN
WA8448490Medicaid