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General NPI Number Information
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NPI Number | 1841508165
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Entity Type | Organization
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Legal Business Name | SOUTHEAST RHEUMATOLOGY & IMMUNOLOGY, LLC
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 72 WASHINGTON ST SUITE 1200
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City | TAUNTON
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State | MA
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Zip | 02780-2491
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Country | US
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Telephone | 508-828-4511
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Fax | 508-828-4512
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Provider Business Mailing Address
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Address Line | 263 WASHINGTON ST
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City | SHERBORN
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State | MA
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Zip | 01770-1019
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Country | US
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Telephone | 508-828-4511
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Fax | 508-828-4512
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. RICHARD I SPERLING
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Credential | M.D.
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Telephone | 508-828-4511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 53669
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License Number State | MA
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