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General NPI Number Information
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NPI Number | 1518914134
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Entity Type | Organization
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Legal Business Name | CHOICES INTEGRATIVE AND PREVENTIVE FAMILY PRACTICE
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 340 MAPLE ST SUITE 300
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City | MARLBOROUGH
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State | MA
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Zip | 01752-3200
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Country | US
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Telephone | 774-463-0001
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2190
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City | WEST PEABODY
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State | MA
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Zip | 01960-7190
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Country | US
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Telephone | 781-231-7026
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BEBERLY WEDDA
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Credential | M.D.
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Telephone | 774-463-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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