# QUINCY PHYSICIAN CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144426503
- **Authorized official:** MRS. VICTORIA DIVAIO-BUSH (DIRECTOR PHYSICIAN SERVICES)
- **Authorized official phone:** (617) 376-4018

## Contact information

- **Practice address:** 114 WHITWELL ST, QUINCY, MA 02169-1870
- **Practice address phone:** (617) 376-4018
- **Practice address fax:** (617) 376-1609
- **Mailing address:** 114 WHITWELL ST, QUINCY, MA 02169-1870
- **Mailing address phone:** (617) 376-4018
- **Mailing address fax:** (617) 376-1609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |

## Other

- **Enumeration date:** 06/22/2007
- **Last updated:** 07/20/2007