Mt Auburn Professional Service

LBN: Mt Auburn Professional Service
Mt Auburn Professional Service is an health care organization with primary practice located at 101 Main St Ste 110, Medford MA 02155-4540. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Mt Auburn Professional Service can be contacted via phone (781) 396-4514, or through Smith, Brian via phone (405) 245-6238.

Contact Information

Primary practice address
101 Main St Ste 110 Medford MA 02155-4540
Phone: (781) 396-4514
Fax: (781) 322-1394
Website:
Map and Directions
Authorized official contact:
Name: Smith, Brian
Phone: (405) 245-6238

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1962686816
LBN Legal business name Mt Auburn Professional Service
DBA Doing business as
Authorized official Smith, Brian
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2007
Last updated May 5th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962686816 NPPES
Massachusetts Other M19292 BLUE CROSS

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