Beacon Primary Medicine, Inc. | |
50 Prospect St Lawrence MA 01841-2841 | |
(617) 794-1463 | |
(617) 739-1963 |
Full Name | Beacon Primary Medicine, Inc. |
---|---|
Speciality | Internal Medicine |
Location | 50 Prospect St, Lawrence, Massachusetts |
Authorized Official Name and Position | Robin Stanton Mayfield (PRESIDENT) |
Authorized Official Contact | 6177941463 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Beacon Primary Medicine, Inc. 50 Prospect St Lawrence MA 01841-2841 Ph: (617) 794-1463 | Beacon Primary Medicine, Inc. 50 Prospect St Lawrence MA 01841-2841 Ph: (617) 794-1463 |
NPI Number | 1790057404 |
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Provider Enumeration Date | 01/27/2012 |
Last Update Date | 01/27/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790057404 | NPI | - | NPPES |
F71191 | Other | UPIN | |
1225098924 | Other | MA | NPI |
J14325 | Other | MEDICARE PROVIDER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 78290 (Massachusetts) | Primary |
208000000X | Pediatrics | 78290 (Massachusetts) | Secondary |
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