Provider Demographics
NPI:1275062283
Name:MILFORD REGIONAL PHYSICIAN GROUP, INC.
Entity Type:Organization
Organization Name:MILFORD REGIONAL PHYSICIAN GROUP, INC.
Other - Org Name:MILFORD REGIONAL URGENT CARE - HOPKINTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCSWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-473-1480
Mailing Address - Street 1:9 INDUSTRIAL RD STE 5
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3736
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:508-473-1210
Practice Address - Street 1:1 LUMBER ST
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748
Practice Address - Country:US
Practice Address - Phone:508-625-3535
Practice Address - Fax:508-625-1973
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILFORD REGIONAL PHYSICIAN GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-05
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110082161UMedicaid