MEDICARE: MOBILE MEDICAL GROUP MA PC

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	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1801112099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE MEDICAL GROUP MA PC

Provider Business Mailing Address
First Line	:	109 RHODE ISLAND RD
Second Line	:
City	:	LAKEVILLE
State	:	MA
Zip	:	02347-1370
Country	:	US
Telephone Number	:	781-489-5717
Fax Number	:	781-772-1332

Provider Business Practice Location Address
First Line	:	109 RHODE ISLAND RD
Second Line	:
City	:	LAKEVILLE
State	:	MA
Zip	:	02347-1370
Country	:	US
Telephone Number	:	781-489-5717
Fax Number	:	781-772-1332

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALAN E. CLAYMAN
Credential	:	MD
Telephone Number	:	781-489-5717

Provider Enumeration Date	:	04/13/2010
Last Update Date	:	02/06/2017

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