# SOUTHCOAST PHYSICIANS GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southcoast Physician Services, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336137629
- **Authorized official:** MELISSA ROSE (SHS VICE PRESIDENT OF CONTRACTING)
- **Authorized official phone:** (508) 973-2950

## Contact information

- **Practice address:** 200 MILL ROAD, SUITE 180, FAIRHAVEN, MA 02719-5252
- **Practice address phone:** (508) 973-2000
- **Practice address fax:** (508) 973-2001
- **Mailing address:** 200 MILL ROAD, SUITE 180, FAIRHAVEN, MA 02719-5252
- **Mailing address phone:** (508) 973-2000
- **Mailing address fax:** (508) 973-2001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/11/2005
- **Last updated:** 06/28/2019