Healthcare Provider Details

I. General information

NPI: 1326014259
Provider Name (Legal Business Name): MOUNT AUBURN CARDIOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MOUNT AUBURN ST SUITE 310
CAMBRIDGE MA
02138-5600
US

IV. Provider business mailing address

10 LITTLE BROOK RD
WEST WAREHAM MA
02576-1222
US

V. Phone/Fax

Practice location:
  • Phone: 617-497-1560
  • Fax: 617-497-1109
Mailing address:
  • Phone: 800-841-5200
  • Fax: 508-273-1241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateMA

VIII. Authorized Official

Name: ROBERT J CAMPBELL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 617-497-1560