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General NPI Number Information
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NPI Number | 1700935442
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Entity Type | Organization
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Legal Business Name | TEMPLE MEDICAL PRACTICE, P.C
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 966 PARK ST SUITE C2-1
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City | STOUGHTON
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State | MA
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Zip | 02072-3650
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Country | US
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Telephone | 781-297-8872
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Fax | 781-297-8873
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Provider Business Mailing Address
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Address Line | 966 PARK ST SUITE C2-1
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City | STOUGHTON
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State | MA
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Zip | 02072-3650
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Country | US
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Telephone | 781-297-8872
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Fax | 781-297-8873
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEBBIE FUENTES
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Credential |
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Telephone | 781-297-8875
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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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