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NPI Code Detail

MEDICARE: DEDHAM MEDICAL ASSOCIATES

MEDICARE: DEDHAM MEDICAL ASSOCIATES
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
1291U00000XClinical Medical Laboratory2994MA

General Provider Information

NPI Number : 1467756031
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEDHAM MEDICAL ASSOCIATES
Provider Business Mailing Address
First Line : PO BOX 9120
Second Line :
City : DEDHAM
State : MA
Zip : 02027-9120
Country : US
Telephone Number : 781-329-1400
Fax Number :
Provider Business Practice Location Address
First Line : 325 RIVER RIDGE DR
Second Line :
City : NORWOOD
State : MA
Zip : 02062-5027
Country : US
Telephone Number : 781-329-1400
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : SUZANNE DAVIS
Credential :
Telephone Number : 781-278-5512
Provider Enumeration Date : 12/22/2010
Last Update Date : 12/22/2010

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Directions to “DEDHAM MEDICAL ASSOCIATES ” Practice Location

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