Provider Demographics
NPI:1144327214
Name:MARELLA, PAULA M (DPM)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:MARELLA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:95 TREMONT ST STE 5
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4738
Mailing Address - Country:US
Mailing Address - Phone:781-934-8447
Mailing Address - Fax:781-934-8446
Practice Address - Street 1:95 TREMONT ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4738
Practice Address - Country:US
Practice Address - Phone:781-934-8447
Practice Address - Fax:781-934-8446
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2066213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0307459Medicaid
MAX20272Medicare UPIN
MAY75032Medicare PIN