Organization
NEEDHAM ORTHOPEDIC AND SPORTS MEDICINE, LLC
Active
Other names
Needham Orthopedic and Sports Medicine, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L. CORBETT M.D. (MANAGING MEMBER)
(781) 444-5080
Entity
Organization
Contact information
Practice address
300 CHESTNUT ST, SUITE 900, NEEDHAM, MA 02492-2497
(781) 444-5080
(781) 449-5026
Mailing address
300 CHESTNUT ST, SUITE 900, NEEDHAM, MA 02492-2497
(781) 444-5080
(781) 449-5026
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
683459
TUFTS
MA
05
—
9725661
—
MA
01
—
M19911
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS
MA
Enumeration date
08/09/2006
Last updated
04/04/2013
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