Provider Demographics
NPI:1881751394
Name:VALLEN MASHIKIAN, MARGARET ANN (MD)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANN
Last Name:VALLEN MASHIKIAN
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 1:20 MINUTEMAN RD
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3613
Mailing Address - Country:US
Mailing Address - Phone:781-749-1294
Mailing Address - Fax:
Practice Address - Street 1:851 MAIN ST
Practice Address - Street 2:SUITE 21
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1612
Practice Address - Country:US
Practice Address - Phone:781-331-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA075928207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA075928OtherTUFTS
MAAA31530OtherHARVARD PILGRIM
MAVAJ17568OtherBLUE CROSS BLUE SHIELD
MA3160432Medicaid
MAA21865Medicare ID - Type Unspecified
MA3160432Medicaid