Provider Demographics
NPI:1427152974
Name:MAHLER, MIRIAM (CNM)
Entity type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:
Last Name:MAHLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-5053
Mailing Address - Fax:617-975-0987
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:CWN 5
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-5053
Practice Address - Fax:617-975-0987
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA188988367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0001963OtherNEIGHBORHOOD HEALTH PLAN
MAP83996Medicare UPIN