Provider Demographics
NPI:1952792657
Name:MAYS, AMALIE THAVIKULWAT (MD)
Entity Type:Individual
Prefix:DR
First Name:AMALIE
Middle Name:THAVIKULWAT
Last Name:MAYS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMALIE
Other - Middle Name:CATHERINE
Other - Last Name:THAVIKULWAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:SHERMAN 231
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-3552
Mailing Address - Fax:617-667-3513
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:SHERMAN 231
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-3552
Practice Address - Fax:617-667-3513
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.071334207R00000X
MA2747152085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine