Provider Demographics
NPI:1417926213
Name:MACHINTON, STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:MACHINTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 847348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-7348
Mailing Address - Country:US
Mailing Address - Phone:508-824-2111
Mailing Address - Fax:508-824-2279
Practice Address - Street 1:95 WASHINGTON ST
Practice Address - Street 2:SUITE 4
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2481
Practice Address - Country:US
Practice Address - Phone:508-824-2111
Practice Address - Fax:508-824-2279
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78165207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3112969Medicaid
MA3112969Medicaid
MAJ30036Medicare ID - Type Unspecified