Healthcare Provider Details
I. General information
NPI: 1982400941
Provider Name (Legal Business Name): RHUMB LINE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
111 WASHINGTON ST STE 104
PLAINVILLE MA
02762-2155
US
IV. Provider business mailing address
152 BELLEVUE RD
WATERTOWN MA
02472-3375
US
V. Phone/Fax
- Phone: 508-699-2222
- Fax:
- Phone: 201-805-5595
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
FRIEDMAN
Title or Position: PRESIDENT
Credential:
Phone: 201-805-5595