NPI 1174560304 · live from the CMS NPI Registry
Brockton Hospital Specialty Physician Group
Internal Medicine in Brockton, MA. National Provider Identifier 1174560304, active.
NPI record
| NPI | 1174560304 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine 207R00000X |
| Practice location | 680 Centre St, Brockton, MA 02302 |
| Practice phone | 508-941-7062 |
| Mailing address | Po Box 847493, Boston, MA 02284 |
| Enumerated | May 31, 2006 |
| Last updated | December 22, 2009 |
| Authorized official | Eugene Wallace, Ceo |
| Other names | Signature Healthcare Brockton Hospital |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emergency Medicine | 207P00000X | — |
| Hospitalist | 208M00000X | — |
| Obstetrics & Gynecology | 207V00000X | — |
| Anesthesiology, Pain Medicine | 207LP2900X | — |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | — |
| Pediatrics | 208000000X | — |
| Surgery | 208600000X | — |
| Internal Medicine, Cardiovascular Disease | 207RC0000X | — |
| Internal Medicine, Endocrinology, Diabetes & Metabolism | 207RE0101X | — |
| Internal Medicine, Pulmonary Disease | 207RP1001X | — |
| Internal Medicine, Rheumatology | 207RR0500X | — |
| Social Worker, Clinical | 1041C0700X | — |
| Internal Medicine, Gastroenterology | 207RG0100X | — |
| Orthopaedic Surgery | 207X00000X | — |
| Internal Medicine primary | 207R00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.