Healthcare Provider Details

I. General information

NPI: 1134187685
Provider Name (Legal Business Name): WEYMOUTH MRI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 LIBBEY INDUSTRIAL PKWY
WEYMOUTH MA
02189-3134
US

IV. Provider business mailing address

420 LIBBEY INDUSTRIAL PKWY
WEYMOUTH MA
02189-3134
US

V. Phone/Fax

Practice location:
  • Phone: 781-331-9880
  • Fax: 781-974-1298
Mailing address:
  • Phone: 781-331-9880
  • Fax: 781-974-1298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateMA

VIII. Authorized Official

Name: MR. MARTIN FOSTER
Title or Position: PRESIDENT
Credential: ESQUIRE
Phone: 781-331-9880