Provider Demographics
NPI:1972132132
Name:MUMFORD, BRIGID SHERIDAN (MD)
Entity type:Individual
Prefix:
First Name:BRIGID
Middle Name:SHERIDAN
Last Name:MUMFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MT AUBURN ST
Mailing Address - Street 2:PARSON 2
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:617-499-5083
Mailing Address - Fax:
Practice Address - Street 1:725 CONCORD AVE STE 3500
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1052
Practice Address - Country:US
Practice Address - Phone:617-354-5452
Practice Address - Fax:617-354-0458
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA1017841207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program