Healthcare Provider Details

I. General information

NPI: 1881628535
Provider Name (Legal Business Name): SOUTH SHORE WOMEN'S HEALTH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 LIBBEY PARKWAY SUITE 105
S WEYMOUTH MA
02189
US

IV. Provider business mailing address

PO BOX 188
S WEYMOUTH MA
02190
US

V. Phone/Fax

Practice location:
  • Phone: 339-201-4120
  • Fax: 339-201-4122
Mailing address:
  • Phone: 339-201-4120
  • Fax: 339-201-4122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARTHA EHRMANN
Title or Position: OFFICER
Credential: MD
Phone: 339-201-4120