Organization
STEWARD PET IMAGING LLC
Active
Other names
Steward PET Imaging LLC at Hawthorn Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT E. GUYON JR. (COO - MANAGING MEMBER)
(617) 789-5047
Entity
Organization
Contact information
Practice address
535 FAUNCE CORNER RD, DARTMOUTH, MA 02747-1242
(877) 877-8455
(866) 927-0079
Mailing address
800 WASHINGTON ST, NORWOOD, MA 02062-3487
(877) 877-8455
(866) 927-0079
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
4NNJ
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110073236M
—
MA
01
—
4NNJ
DEPT PUBLIC HEALTH STATE LICENSE
MA
Enumeration date
02/25/2010
Last updated
12/14/2011
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