MEDICARE: WESTON PRIMARY CARE, 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	207R00000X	Internal Medicine Physician	156870	MA

General Provider Information

NPI Number	:	1982885083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTON PRIMARY CARE, PC

Provider Business Mailing Address
First Line	:	PO BOX 6300
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02940-6300
Country	:	US
Telephone Number	:	401-274-0103
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 COLPITTS RD
Second Line	:	GROUND FLOOR
City	:	WESTON
State	:	MA
Zip	:	02493-1568
Country	:	US
Telephone Number	:	781-891-0906
Fax Number	:	781-891-0912

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	TIMOTHY PAUL MURPHY
Credential	:	MD
Telephone Number	:	781-891-0906

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	06/24/2008

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