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NPI 1053197533

NPI 1053197533 : MGW WELLNESS LLC : NEWTON, MA

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General NPI Number Information
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    NPI Number           |    1053197533
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    Entity Type          |    Organization 
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    Legal Business Name  |    MGW WELLNESS LLC 
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Dates
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    Enumeration Date     |    08/31/2023
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    Last Update Date     |    08/31/2023
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Provider Practice Location Address
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    Address Line         |    86 DEBORAH RD 
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    City                 |    NEWTON
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    State                |    MA
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    Zip                  |    02459-2838
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    Country              |    US
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    Telephone            |    339-225-8151
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    86 DEBORAH RD 
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    City                 |    NEWTON
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    State                |    MA
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    Zip                  |    02459-2838
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    Country              |    US
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    Telephone            |    339-225-8151
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PHYSICIAN
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    Name                 |    DR. MEGHAN  GARCIA-WEBB 
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    Credential           |    MD
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    Telephone            |    339-225-8151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    2083B0002X
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    Taxonomy Name        |    Obesity Medicine (Preventive Medicine) Physician
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    License Number       |    
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    License Number State |    
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