Healthcare Provider Details

I. General information

NPI: 1740436187
Provider Name (Legal Business Name): ERICKSON HEALTH MEDICAL GROUP OF MASSACHUSETTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LINDEN PONDS WAY
HINGHAM MA
02043-3769
US

IV. Provider business mailing address

5525 RESEARCH PARK DR 4TH FLOOR
BALTIMORE MD
21228-4664
US

V. Phone/Fax

Practice location:
  • Phone: 781-534-7100
  • Fax: 781-534-7358
Mailing address:
  • Phone: 410-402-2258
  • Fax: 410-204-7279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW NARRETT
Title or Position: EXECUTIVE VP/CHIEF MEDICAL OFFICER
Credential: MD
Phone: 401-402-2261