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General NPI Number Information
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NPI Number | 1548079080
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Entity Type | Organization
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Legal Business Name | REGAL MEDICAL GROUP
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 255 PARK AVE STE 400
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City | WORCESTER
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State | MA
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Zip | 01609-1989
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Country | US
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Telephone | 508-755-9776
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Fax | 508-793-0715
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Provider Business Mailing Address
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Address Line | 255 PARK AVE STE 400
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City | WORCESTER
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State | MA
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Zip | 01609-1989
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Country | US
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Telephone | 508-755-9776
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Fax | 508-831-7861
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Authorized Official
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Title or Position | DIRECTOR
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Name | AL NAWAB
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Credential |
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Telephone | 508-925-0073
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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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