Healthcare Provider Details

I. General information

NPI: 1356421945
Provider Name (Legal Business Name): HINGHAM WEYMOUTH FAMILY MEDICAL ASSOC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 03/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 BRIDGE STREET
WEYMOUTH MA
02191
US

IV. Provider business mailing address

795 BRIDGE STREET
WEYMOUTH MA
02191
US

V. Phone/Fax

Practice location:
  • Phone: 781-337-4105
  • Fax: 781-337-6239
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number43429
License Number StateMA

VIII. Authorized Official

Name: MARTIN ISER
Title or Position: PRESIDENT HWFM
Credential: MD
Phone: 781-337-4105