Provider Demographics
NPI:1417107723
Name:HOPKINTON MEDICAL CARE, P.C.
Entity Type:Organization
Organization Name:HOPKINTON MEDICAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BUNDIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SOPCHOCKCHAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-435-6900
Mailing Address - Street 1:73 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1619
Mailing Address - Country:US
Mailing Address - Phone:508-435-6900
Mailing Address - Fax:508-435-6999
Practice Address - Street 1:73 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1619
Practice Address - Country:US
Practice Address - Phone:508-435-6900
Practice Address - Fax:508-435-6999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55412208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB74611Medicare UPIN