Organization
QUINCY MEDICAL CENTER
Active
Other names
HOSPITALIST PHYSICIANS AT QUINCY MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A GRONBERG (VP CFO)
(617) 773-6100
Entity
Organization
Contact information
Practice address
114 WHITWELL ST, QUINCY, MA 02169-1870
(617) 773-6100
Mailing address
12 GILL ST, WOBURN, MA 01801-1728
(781) 937-4522
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1212575
—
MA
01
—
M17847
BCBS OF MA
MA
Enumeration date
06/16/2006
Last updated
09/11/2025
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