Organization
PMG PHYSICIAN ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GRACE M.D. (PRESIDENT)
(508) 746-7543
Entity
Organization
Contact information
Practice address
139 SANDWICH ST, PLYMOUTH, MA 02360-2449
(508) 746-5773
Mailing address
139 SANDWICH ST, PLYMOUTH, MA 02360-2449
(508) 746-5773
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
208000000X
Pediatrics Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9771433
—
MA
01
—
M16553
BCBSMA
MA
Enumeration date
12/11/2006
Last updated
01/09/2013
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