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NPI Code Detail

MEDICARE: MHG PHYSICIAN SERVICES - WASHINGTON, PLLC

MEDICARE: MHG PHYSICIAN SERVICES - WASHINGTON, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1356070023
Entity Type Code : Organization
Provider Name (Legal Business Name) : MHG PHYSICIAN SERVICES - WASHINGTON, PLLC
Provider Business Mailing Address
First Line : 500 HARRISON AVE
Second Line :
City : BOSTON
State : MA
Zip : 02118-2439
Country : US
Telephone Number : 850-344-4663
Fax Number :
Provider Business Practice Location Address
First Line : 711 CAPITOL WAY S STE 204
Second Line :
City : OLYMPIA
State : WA
Zip : 98501-1267
Country : US
Telephone Number : 850-344-4663
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : DR. ROBERT ROTHSTEIN
Credential : MD
Telephone Number : 850-344-4663
Provider Enumeration Date : 06/08/2022
Last Update Date : 05/05/2023

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