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General NPI Number Information
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NPI Number | 1588118046
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Entity Type | Organization
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Legal Business Name | PRISM MEDICAL ASSOCIATES,LLC
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 08/19/2016
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Provider Practice Location Address
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Address Line | 1421 ORLEANS RD
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City | HARWICH
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State | MA
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Zip | 02645-2148
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Country | US
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Telephone | 508-430-1220
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Fax | 508-430-5029
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Provider Business Mailing Address
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Address Line | 1421 ORLEANS RD
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City | HARWICH
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State | MA
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Zip | 02645-2148
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Country | US
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Telephone | 508-430-1220
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Fax | 508-430-5029
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | MOHAMMAD ARSHAD
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Credential | D.O
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Telephone | 774-413-0976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 234328
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License Number State | MA
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