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NPI Code Detail

MEDICARE: TRISTAN MEDICAL ENTERPRISES PC

MEDICARE: TRISTAN MEDICAL ENTERPRISES PC
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
1207Q00000XFamily Medicine PhysicianMA

General Provider Information

NPI Number : 1538398326
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRISTAN MEDICAL ENTERPRISES PC
Provider Business Mailing Address
First Line : 465 S WASHINGTON ST
Second Line :
City : NORTH ATTLEBORO
State : MA
Zip : 02760-2159
Country : US
Telephone Number : 508-316-0725
Fax Number : 508-316-3060
Provider Business Practice Location Address
First Line : 465 S WASHINGTON ST
Second Line :
City : NORTH ATTLEBORO
State : MA
Zip : 02760-2159
Country : US
Telephone Number : 508-316-0725
Fax Number : 508-316-3060
Authorized Official
Title or Position : OWNER
Name : RYAN WELTER
Credential : MD
Telephone Number : 508-316-0725
Provider Enumeration Date : 07/14/2009
Last Update Date : 03/25/2021

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Directions to “TRISTAN MEDICAL ENTERPRISES PC ” Practice Location

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