Healthcare Provider Details

I. General information

NPI: 1982742532
Provider Name (Legal Business Name): PROFESSIONAL MEDICAL ASSOCIATES,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 FRANKLIN ST SUITE 203
FRAMINGHAM MA
01702-6264
US

IV. Provider business mailing address

475 FRANKLIN ST SUITE 203
FRAMINGHAM MA
01702-6264
US

V. Phone/Fax

Practice location:
  • Phone: 508-879-4407
  • Fax: 508-620-9395
Mailing address:
  • Phone: 508-879-4407
  • Fax: 508-620-9395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number44666
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number155016
License Number StateMA

VIII. Authorized Official

Name: MRS. GAIL A MURPHY
Title or Position: OFFICE MANAGER
Credential:
Phone: 508-879-4407