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General NPI Number Information
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NPI Number | 1457417669
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Entity Type | Organization
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Legal Business Name | JAMES MARQUARDT, MD, PC.
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 47 LIBBY ST
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City | BROCKTON
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State | MA
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Zip | 02302-2949
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Country | US
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Telephone | 781-585-9522
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Fax | 781-585-9544
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Provider Business Mailing Address
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Address Line | 47 LIBBY ST
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City | BROCKTON
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State | MA
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Zip | 02302-2949
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Country | US
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Telephone | 781-585-9522
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Fax | 781-585-9544
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES MARQUARDT
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Credential | MD
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Telephone | 781-585-9522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 71651
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License Number State | MA
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