Organization
BEACON PRIMARY MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBIN STANTON MAYFIELD M.D. (PRESIDENT)
(617) 794-1463
Entity
Organization
Contact information
Practice address
50 PROSPECT ST, LAWRENCE, MA 01841-2841
(617) 794-1463
(617) 739-1963
Mailing address
50 PROSPECT ST, LAWRENCE, MA 01841-2841
(617) 794-1463
(617) 739-1963
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
78290
MA
208000000X
Pediatrics Physician
78290
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225098924
NPI
MA
01
—
F71191
UPIN
—
01
—
J14325
MEDICARE PROVIDER
—
Enumeration date
01/27/2012
Last updated
01/27/2012
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