Lakeside Family Practice Pc | |
416 Broadway Raynham MA 02767-1737 | |
(508) 828-5020 | |
(508) 386-1323 |
Full Name | Lakeside Family Practice Pc |
---|---|
Speciality | Clinic/Center |
Location | 416 Broadway, Raynham, Massachusetts |
Authorized Official Name and Position | Cheng Chuang (PRESIDENT) |
Authorized Official Contact | 5088285020 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lakeside Family Practice Pc 416 Broadway Raynham MA 02767-1737 Ph: (508) 828-5020 | Lakeside Family Practice Pc 416 Broadway Raynham MA 02767-1737 Ph: (508) 828-5020 |
NPI Number | 1528176179 |
---|---|
Provider Enumeration Date | 08/25/2006 |
Last Update Date | 10/19/2011 |
Medicare PECOS PAC ID | 1153364666 |
---|---|
Medicare Enrollment ID | O20050606001047 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528176179 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Cheng-chieh Chuang |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245344423 PECOS PAC ID: 3870536394 Enrollment ID: I20111019000106 |
Mass Wellness Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 675 Paramount Dr Ste 205a, Raynham, MA 02767 Phone: 617-833-5626 |