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General NPI Number Information
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NPI Number | 1548375652
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Entity Type | Organization
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Legal Business Name | BAYSIDE EMERGENCY MEDICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 275 SANDWICH ST
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City | PLYMOUTH
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State | MA
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Zip | 02360-2183
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Country | US
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Telephone | 508-746-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 6 LAKEVILLE BUSINESS PARK
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City | LAKEVILLE
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State | MA
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Zip | 02347-1234
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Country | US
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Telephone | 508-947-7558
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Fax | 508-946-1494
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Authorized Official
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Title or Position | CHARIMAN/DEPARTMENT OF EMERG MED
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Name | DONALD HANSEN
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Credential | MD
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Telephone | 508-746-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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