Provider Demographics
NPI:1952403370
Name:SCHONBERG, MARA A (MD)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:A
Last Name:SCHONBERG
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:BETH ISRAEL DEACONESS MEDICAL
Mailing Address - Street 2:330 BROOKLINE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-9600
Mailing Address - Fax:
Practice Address - Street 1:BETH ISRAEL DEACONESS MEDICAL
Practice Address - Street 2:330 BROOKLINE AVE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213492207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine