Provider Demographics
NPI:1356462964
Name:COMPASS MEDICAL PC
Entity Type:Organization
Organization Name:COMPASS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT COMPASS MEDICAL PC
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLAIRMONT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-583-8193
Mailing Address - Street 1:500 BELMONT ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301
Mailing Address - Country:US
Mailing Address - Phone:508-583-8193
Mailing Address - Fax:508-427-6974
Practice Address - Street 1:1690 MAIN ST
Practice Address - Street 2:SUITE #4
Practice Address - City:SO WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190
Practice Address - Country:US
Practice Address - Phone:781-337-8688
Practice Address - Fax:781-337-8754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM21413Medicare ID - Type Unspecified