MEDICARE: PARKWAY ORTHOPEDICS & SPORTS MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	46262	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457341331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKWAY ORTHOPEDICS & SPORTS MEDICINE

Provider Business Mailing Address
First Line	:	968 SOUTH ST
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-2314
Country	:	US
Telephone Number	:	617-323-3334
Fax Number	:	617-327-9330

Provider Business Practice Location Address
First Line	:	968 SOUTH ST
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-2314
Country	:	US
Telephone Number	:	617-323-3334
Fax Number	:	617-327-9330

Authorized Official
Title or Position	:	BILLING
Name	:	MRS. CHRISTINE SOARES
Credential	:
Telephone Number	:	508-679-9032

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	09/12/2008

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1285061804 — MRS. ROSEMARY M MATEJKA PA-C
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1770416422 — PATRICIA DE LOS SANTOS
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1982607917 — FREDERICK ROWLAND MD
Practice Location Address:

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Directions to “PARKWAY ORTHOPEDICS & SPORTS MEDICINE ” Practice Location

Language	Start Address	Practice Location

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