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General NPI Number Information
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NPI Number | 1215093968
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Entity Type | Individual
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Provider Name | MEREDITH FAGGEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 541 MAIN ST SUITE 414
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City | S WEYMOUTH
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State | MA
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Zip | 02190-1868
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Country | US
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Telephone | 781-952-1650
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Fax | 781-331-4936
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Provider Business Mailing Address
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Address Line | 541 MAIN ST SUITE 414
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City | S WEYMOUTH
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State | MA
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Zip | 02190-1868
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Country | US
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Telephone | 781-952-1650
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Fax | 781-331-4936
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD12408
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License Number State | RI
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