Provider Demographics
NPI:1609825587
Name:MEHL, ROSEMARY
Entity type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:
Last Name:MEHL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 WFW PARKWAY
Mailing Address - Street 2:11PC
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-4927
Mailing Address - Country:US
Mailing Address - Phone:857-364-4418
Mailing Address - Fax:857-364-5365
Practice Address - Street 1:1400 VFW PKWY
Practice Address - Street 2:11PC
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:857-364-4418
Practice Address - Fax:857-203-5645
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54239207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine