Provider Demographics
NPI:1104053693
Name:MARSTERS, MARY DUBEAU (RDCS)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:DUBEAU
Last Name:MARSTERS
Suffix:
Gender:F
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 FALMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3968
Mailing Address - Country:US
Mailing Address - Phone:508-477-6726
Mailing Address - Fax:
Practice Address - Street 1:509 FALMOUTH RD
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-2699
Practice Address - Country:US
Practice Address - Phone:508-477-6726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14223246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography