Healthcare Provider Details

I. General information

NPI: 1245277433
Provider Name (Legal Business Name): NEHE WSIC II, LLC , DBA METROSOUTH MRI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LIBERTY ST
BROCKTON MA
02301
US

IV. Provider business mailing address

801 MAIN ST., SUITE 9
CONCORD MA
01742
US

V. Phone/Fax

Practice location:
  • Phone: 508-588-6606
  • Fax: 508-588-1643
Mailing address:
  • Phone: 978-369-1290
  • Fax: 978-369-5101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Internal Medicine Physician
License Number4355
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4355
License Number StateMA

VIII. Authorized Official

Name: MRS. ROSEMARY BARNETT
Title or Position: SENIOR VICE PRESIDENT
Credential: V.P.
Phone: 978-369-1290