| NPI | 1235754995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GRANDISON FAIRCHILD Cmo,Owner 617-276-5349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 104100000X Social Worker |
| 207R00000X Internal Medicine | |
| 261QP2300X Clinic/Center, Primary Care | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2024-11-14 |