King, Maryetta E.
King, Maryetta E. is an individual health care provider with primary practice located at 55 Fruit Street Yawkey 5-062 Massachusetts General Hospital, Boston MA 02114-2696. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. King, Maryetta E. can be contacted via phone (617) 726-3826.Contact Information
Primary practice address
55 Fruit Street Yawkey 5-062 Massachusetts General Hospital
Boston MA 02114-2696
Phone: (617) 726-3826
Fax: (617) 643-1639
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 38249 | Massachusetts |
Profile Details
| NPI number | 1962492603 |
|---|---|
| LBN Legal business name | King, Maryetta E. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2005 |
| Last updated | Sep 2nd, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962492603 | NPPES |
| Massachusetts | Other | 724773 | TUFTS HEALTH PLAN |
| Massachusetts | Other | B11517 | TUFTS HEALTH PLAN |
| Massachusetts | MEDICAID | 6171613 | TUFTS HEALTH PLAN |
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