Provider Demographics
NPI:1154514107
Name:H AND G MEDICAL GROUP LLC
Entity type:Organization
Organization Name:H AND G MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-528-8977
Mailing Address - Street 1:9 SUMMER ST
Mailing Address - Street 2:UNIT205
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-1491
Mailing Address - Country:US
Mailing Address - Phone:508-528-8977
Mailing Address - Fax:
Practice Address - Street 1:9 SUMMER ST
Practice Address - Street 2:UNIT205
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-1491
Practice Address - Country:US
Practice Address - Phone:508-528-8977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155994207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM21349Medicare PIN