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General NPI Number Information
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NPI Number | 1174364723
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Entity Type | Organization
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Legal Business Name | MEDFIELD INTERNAL MEDICINE, PLLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 266 MAIN ST STE 4
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City | MEDFIELD
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State | MA
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Zip | 02052-2018
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Country | US
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Telephone | 508-359-8141
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Fax | 508-359-8005
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Provider Business Mailing Address
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Address Line | 266 MAIN ST STE 4
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City | MEDFIELD
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State | MA
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Zip | 02052-2018
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Country | US
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Telephone | 508-359-8141
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Fax | 508-359-8005
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | RUSSELL E KLING
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Credential | MD
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Telephone | 508-359-8141
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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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