Healthcare Provider Details

I. General information

NPI: 1962796706
Provider Name (Legal Business Name): NORTH SHORE SHOULDER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 BOSTON PROVIDENCE TPKE STE 14
NORWOOD MA
02062-4946
US

IV. Provider business mailing address

520 BOSTON PROVIDENCE TPKE STE 14
NORWOOD MA
02062-4946
US

V. Phone/Fax

Practice location:
  • Phone: 978-969-3624
  • Fax: 617-977-1543
Mailing address:
  • Phone: 978-969-3624
  • Fax: 617-977-1543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number216781
License Number StateMA

VIII. Authorized Official

Name: ROBERT E MCLAUGHLIN
Title or Position: PRESIDENT
Credential:
Phone: 978-969-3624