Healthcare Provider Details
I. General information
NPI: 1508681321
Provider Name (Legal Business Name): MILFORD REGIONAL PHYSICIAN GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
68A MAIN ST STE 101A
MEDWAY MA
02053-1775
US
IV. Provider business mailing address
9 INDUSTRIAL RD STE 5
MILFORD MA
01757-3736
US
V. Phone/Fax
- Phone: 508-321-2844
- Fax:
- Phone: 508-473-1480
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICK
R
MCSWEENEY
Title or Position: PRESIDENT
Credential: MD
Phone: 508-473-1480