Mystic Medical Group, Inc.
LBN: Mystic Medical Group, Inc.
Mystic Medical Group, Inc. is an health care organization with primary practice located at 170 Governors Ave , Medford MA 02155-1643. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is the primary health care specialty.
Mystic Medical Group, Inc. can be contacted via phone (781) 391-4106, or through Weinstein, Robert S via phone (781) 391-0801.
Contact Information
Primary practice address
170 Governors Ave
Medford MA 02155-1643
Phone: (781) 391-4106
Fax: (781) 391-3043
Website:
Authorized official contact:
Name: Weinstein, Robert S Doctor of Medicine (MD)
Phone: (781) 391-0801
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | ||
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X |
Profile Details
| NPI number | 1245218676 |
|---|---|
| LBN Legal business name | Mystic Medical Group, Inc. |
| DBA Doing business as | |
| Authorized official | Weinstein, Robert S Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 5th, 2006 |
| Last updated | Oct 21st, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245218676 | NPPES |
| Other | 688708 | TUFTS GROUP | |
| Other | M17957 | TUFTS GROUP |
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