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42 Tremont St Ste 10b Duxbury MA 02332-5313 | |
| (781) 589-8929 | |
| (888) 297-6967 |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 42 Tremont St Ste 10b, Duxbury, Massachusetts |
| Authorized Official Name and Position | Maura S Davis (OWNER/PARTNER) |
| Authorized Official Contact | 7815898929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
42 Tremont St Ste 10b Duxbury MA 02332-5313 Ph: (781) 589-8929 | 42 Tremont St Ste 10b Duxbury MA 02332-5313 Ph: (781) 589-8929 |
| NPI Number | 1679211833 |
|---|---|
| Provider Enumeration Date | 05/26/2022 |
| Last Update Date | 02/05/2024 |
| Certification Date | 02/05/2024 |
| Medicare PECOS PAC ID | 4385187533 |
|---|---|
| Medicare Enrollment ID | O20240617002540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679211833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Maura T Mcmann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740373695 PECOS PAC ID: 3476525759 Enrollment ID: I20040807000227 |
| Provider Name | Maura S Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184843088 PECOS PAC ID: 9335486141 Enrollment ID: I20190131001318 |
| Provider Name | Susan Ouellette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720164320 PECOS PAC ID: 4880611458 Enrollment ID: I20210420000727 |
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