Provider Demographics
NPI:1164630885
Name:JAMES MARQUARDT, MD, PC
Entity Type:Organization
Organization Name:JAMES MARQUARDT, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MARQUARDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-585-9522
Mailing Address - Street 1:47 LIBBY ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2949
Mailing Address - Country:US
Mailing Address - Phone:781-585-9522
Mailing Address - Fax:781-585-9544
Practice Address - Street 1:47 LIBBY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2949
Practice Address - Country:US
Practice Address - Phone:781-585-9522
Practice Address - Fax:781-585-9544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA735413207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM16852OtherBLUE CROSS BLUE SHIELD