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General NPI Number Information
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NPI Number | 1669360277
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Entity Type | Organization
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Legal Business Name | MA ORTHO SPINE, PLLC
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 697 CAMBRIDGE ST STE 205
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City | BRIGHTON
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State | MA
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Zip | 02135-2897
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Country | US
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Telephone | 844-733-3774
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Fax |
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Provider Business Mailing Address
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Address Line | 697 CAMBRIDGE ST STE 205
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City | BRIGHTON
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State | MA
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Zip | 02135-2897
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Country | US
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Telephone | 844-733-3774
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ROSS SHERBAN
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Credential | DO
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Telephone | 844-733-3774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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