NPI | 1174281893 |
---|---|
Former Legal Business Name | 3745 11TH CIRCLE STE 101 |
Entity Type | Organization |
Authorized Contact | AMY MARIE GUAY President Of Smg 617-562-7070 |
Organization Subpart ? | No |
Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
Additional Taxonomies | 208800000X Urology |
Enumeration Date | 2021-11-30 |
Last Update Date | 2021-11-30 |