Provider Demographics
NPI: | 1124079561 |
---|---|
Name: | HARBOR MEDICAL ASSOCIATES, INC. |
Entity type: | Organization |
Organization Name: | HARBOR MEDICAL ASSOCIATES, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SARATHCHANDRA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | REDDY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 781-848-6040 |
Mailing Address - Street 1: | 541 MAIN ST |
Mailing Address - Street 2: | SUITE 400 |
Mailing Address - City: | SOUTH WEYMOUTH |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 02190-1868 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 781-952-1240 |
Mailing Address - Fax: | 781-952-1257 |
Practice Address - Street 1: | 541 MAIN ST |
Practice Address - Street 2: | SUITE 400 |
Practice Address - City: | SOUTH WEYMOUTH |
Practice Address - State: | MA |
Practice Address - Zip Code: | 02190-1868 |
Practice Address - Country: | US |
Practice Address - Phone: | 781-952-1240 |
Practice Address - Fax: | 781-952-1257 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-12 |
Last Update Date: | 2025-02-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207Q00000X, 207R00000X, 207RC0001X, 207RE0101X, 207RG0100X, 207RH0003X, 207RI0011X, 207RP1001X, 207RS0012X, 207RC0000X | ||
MA | 207UN0901X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | Group - Multi-Specialty |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | Group - Multi-Specialty |
No | 207UN0901X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MA | 0009288 | Other | NEIGHBORHOOD HEALTH PLAN |
MA | 603236 | Other | TUFTS GROUP NUMBER |
MA | 9741194 | Medicaid | |
MA | M13981 | Other | BLUE CROSS BLUE SHIELD |
MA | 084 | Other | TUFTS MEDICARE PREFERRED |
MA | 24323 | Other | FALLON COMM HEALTH PLAN |
MA | 603236 | Other | TUFTS GROUP NUMBER |