Provider Demographics
NPI:1053462259
Name:SOUTH SHORE MIDWIFERY
Entity Type:Organization
Organization Name:SOUTH SHORE MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARQUARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-871-2822
Mailing Address - Street 1:2100 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1657
Mailing Address - Country:US
Mailing Address - Phone:781-871-2822
Mailing Address - Fax:781-871-3996
Practice Address - Street 1:2100 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1657
Practice Address - Country:US
Practice Address - Phone:781-871-2822
Practice Address - Fax:781-871-3996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty