Advantage Surgical And Wound Care Massachusetts PC
Surgery in Revere, MA. Organization (NPI-2).
NPI number1164039152
StatusActive
Last updated in NPPESSep 24, 2020
Details
- NPI
- 1164039152
- Entity type
- Organization (NPI-2)
- Legal business name
- Advantage Surgical And Wound Care Massachusetts PC
- Organization subpart
- No
- Enumeration date
- Sep 24, 2020
- Certification date
- Sep 24, 2020
- Last updated
- Sep 24, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | – | – | Yes |
| 207PE0005X | Emergency Medicine, Undersea and Hyperbaric Medicine | – | – |
Practice location
204 Proctor AveRevere, MA 02151-4923
Phone 877-878-3289 · Fax 877-817-3227
Mailing address
222 N Pacific Coast Hwy Ste 2175El Segundo, CA 90245-5639
Phone 877-878-3289 · Fax 877-817-3227
Authorized official
John Griffin
President
8778783289
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