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Organization

MT AUBURN PROFESSIONAL SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRIAN SMITH (CFO)
(405) 245-6238
Entity
Organization

Contact information

Practice address
101 MAIN ST, STE 110, MEDFORD, MA 02155-4540
(781) 396-4514
(781) 322-1394
Mailing address
ONE ARSENAL MARKETPLACE, WATERTOWN, MA 02472
(617) 673-1851
(617) 499-5579

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M19292
BLUE CROSS
MA
Enumeration date
12/27/2007
Last updated
05/05/2024
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