MEDICARE: RADIOLOGY ASSOCIATES OF PLYMOUTH

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
1	2085R0202X	Diagnostic Radiology Physician		MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972580439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIOLOGY ASSOCIATES OF PLYMOUTH

Provider Business Mailing Address
First Line	:	PO BOX 9137
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-9137
Country	:	US
Telephone Number	:	800-927-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 SANDWICH ST
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-2183
Country	:	US
Telephone Number	:	508-830-2120
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	RONALD GOLDBERG
Credential	:	MD
Telephone Number	:	800-927-0002

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	08/22/2020

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