# MWHLPHO

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

## Provider details

- **NPI number:** 1447732573
- **Authorized official:** TRICIA BRISBOIS (MANAGER)
- **Authorized official phone:** (978) 764-8628

## Contact information

- **Practice address:** 13 BRADLEE ROAD, MEDFORD, MA 02155
- **Practice address phone:** (781) 395-1110
- **Practice address fax:** (781) 395-8553
- **Mailing address:** 13 BRADLEE ROAD, MEDFORD, MA 02155
- **Mailing address phone:** (781) 395-1110
- **Mailing address fax:** (781) 395-8553

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 60673 | MA | Yes |

## Other

- **Enumeration date:** 09/05/2018
- **Last updated:** 12/27/2021