Healthcare Provider Details

I. General information

NPI: 1831526193
Provider Name (Legal Business Name): APEX MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHLAND ST STE 103
MILTON MA
02186-3801
US

IV. Provider business mailing address

100 HIGHLAND ST STE 103
MILTON MA
02186-3801
US

V. Phone/Fax

Practice location:
  • Phone: 617-696-9600
  • Fax: 617-453-5060
Mailing address:
  • Phone: 617-696-9600
  • Fax: 617-453-5060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number242209
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number242209
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number242209
License Number StateMA

VIII. Authorized Official

Name: SARASWATHI VENKATA MUPPANA
Title or Position: MD
Credential:
Phone: 718-374-1538