Organization
MEDICAL GROUP INC
Active
Other names
Cardiopulmonary Lab
Organization subpart
No
Provider details
NPI number
Authorized official
HARRIET A BERING MD (PRESIDENT)
(978) 927-4110
Entity
Organization
Contact information
Practice address
77 HERRICK ST, SUITE 101, BEVERLY, MA 01915-3012
(978) 927-4110
(978) 232-7057
Mailing address
77 HERRICK ST, STITE 101, BEVERLY, MA 01915-3012
(978) 927-4110
(978) 232-7057
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2474
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0804436
—
MA
01
—
M16434
BLUE SHIELD
—
Enumeration date
08/21/2006
Last updated
12/21/2009
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