Individual
DR. JUSTIN SANDERS GROODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
372 WASHINGTON ST, MARINO CENTER FOR INTEGRATIVE HEALTH, WELLESLEY, MA 02481-6202
(781) 235-5200
(617) 682-1101
Mailing address
372 WASHINGTON ST, WELLESLEY, MA 02481-6202
(781) 235-5200
(781) 235-1103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
243102
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M21670
MEDICARE PROVIDER GROUP
MA
Enumeration date
11/15/2007
Last updated
09/01/2011
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