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General NPI Number Information
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NPI Number | 1184675779
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Entity Type | Organization
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Legal Business Name | DARTMOUTH MEDICAL WALK-IN PC II
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 210 WASHINGTON ST
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City | FAIRHAVEN
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State | MA
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Zip | 02719-4044
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Country | US
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Telephone | 508-992-5546
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Fax | 508-990-0391
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Provider Business Mailing Address
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Address Line | 210 WASHINGTON ST
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City | FAIRHAVEN
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State | MA
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Zip | 02719-4044
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Country | US
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Telephone | 508-992-5546
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Fax | 508-990-0391
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JOY A GAGLIARDI
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Credential |
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Telephone | 508-992-5546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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