Organization
HERITAGE MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURA SCANZILLO (PRESIDENT)
(781) 837-7141
Entity
Organization
Contact information
Practice address
280 HERITAGE PARK, HERITAGE MEDICAL GROUP, SANDWICH, MA 02563
(781) 827-7141
(781) 834-4292
Mailing address
PO BOX 489, ROCKLAND, MA 02370-0489
(800) 720-1664
(207) 753-2020
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9739050
—
MA
01
—
DC0220
RAILROAD MEDICARE
—
Enumeration date
05/30/2006
Last updated
11/07/2007
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