Provider Demographics
NPI:1528265824
Name:MASSELAM HATCH, KATHRYN L (MD)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:L
Last Name:MASSELAM HATCH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1601 TRAPELO RD
Mailing Address - Street 2:SUITE 184
Mailing Address - City:WATHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451
Mailing Address - Country:US
Mailing Address - Phone:781-890-1023
Mailing Address - Fax:781-890-2507
Practice Address - Street 1:1601 TRAPELO RD
Practice Address - Street 2:SUITE 184
Practice Address - City:WATHAM
Practice Address - State:MA
Practice Address - Zip Code:02451
Practice Address - Country:US
Practice Address - Phone:781-890-1023
Practice Address - Fax:781-890-2507
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2013-02-25
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Provider Licenses
StateLicense IDTaxonomies
MA231448207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA231448OtherLICENSE
J42117Medicare PIN