Provider Demographics
NPI:1093827438
Name:MILTON CARDIAC TESTING, P.C.
Entity Type:Organization
Organization Name:MILTON CARDIAC TESTING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:T
Authorized Official - Last Name:HODGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-696-3219
Mailing Address - Street 1:92 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3800
Mailing Address - Country:US
Mailing Address - Phone:617-696-3219
Mailing Address - Fax:617-696-9577
Practice Address - Street 1:92 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3800
Practice Address - Country:US
Practice Address - Phone:617-696-3219
Practice Address - Fax:617-696-9577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9756965Medicaid
MA9756965Medicaid