Provider Demographics
NPI:1598948846
Name:MEDWAR, MARY P (DC)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:P
Last Name:MEDWAR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W CUMMINGS PARK STE 4700
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6554
Mailing Address - Country:US
Mailing Address - Phone:781-324-2330
Mailing Address - Fax:781-324-6836
Practice Address - Street 1:800 W CUMMINGS PARK STE 4700
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6554
Practice Address - Country:US
Practice Address - Phone:781-324-2330
Practice Address - Fax:781-324-6836
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACHI1045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35729OtherBLUE CROSS BLUE SHIELD
MAY35729OtherBLUE CROSS BLUE SHIELD