Healthcare Provider Details

I. General information

NPI: 1366554776
Provider Name (Legal Business Name): MELINDA G. RABOIN, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 GROTON RD
WESTFORD MA
01886-6307
US

IV. Provider business mailing address

506 GROTON RD
WESTFORD MA
01886-6307
US

V. Phone/Fax

Practice location:
  • Phone: 978-692-1222
  • Fax: 978-692-1322
Mailing address:
  • Phone: 978-692-1222
  • Fax: 978-692-1322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number75223
License Number StateMA

VIII. Authorized Official

Name: DR. MELINDA G RABOIN
Title or Position: OWNER
Credential: MD
Phone: 978-692-1222