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General NPI Number Information
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NPI Number | 1396942926
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Entity Type | Organization
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Legal Business Name | HARBOR MEDICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 08/07/2017
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Provider Practice Location Address
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Address Line | 541 MAIN ST SUITE 420
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City | SOUTH 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 | 781-952-1367
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Fax | 781-952-1379
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Provider Business Mailing Address
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Address Line | 541 MAIN ST SUITE 420
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City | SOUTH 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 | 781-952-1367
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Fax | 781-952-1379
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Authorized Official
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Title or Position | CHIEF
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Name | DR. PETER GRAPE
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Credential | MD
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Telephone | 781-952-1249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 59350
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License Number State | MA
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