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General NPI Number Information
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NPI Number | 1245051721
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Entity Type | Organization
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Legal Business Name | MAGNUM HEALTH CARE LLC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 100 OLD BILLERICA RD
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City | BEDFORD
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State | MA
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Zip | 01730-1267
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Country | US
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Telephone | 617-834-9741
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Fax |
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Provider Business Mailing Address
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Address Line | 31 PINE ST
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City | WESTON
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State | MA
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Zip | 02493-1115
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Country | US
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Telephone | 617-834-9741
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Fax |
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Authorized Official
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Title or Position | MD
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Name | ASHMEET BHATIA
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Credential |
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Telephone | 617-834-9741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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