# MEDIGROUP PC

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

## Provider details

- **NPI number:** 1669588372
- **Authorized official:** DR. MARK WEINER M.D. (OWNER)
- **Authorized official phone:** (781) 986-1737

## Contact information

- **Practice address:** 4 FRANK LEARY WAY, RANDOLPH, MA 02368-4512
- **Practice address phone:** (781) 986-1737
- **Practice address fax:** (781) 986-0507
- **Mailing address:** 4 FRANK LEARY WAY, RANDOLPH, MA 02368-4512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | 54262 | MA | Yes |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 09/10/2007