Provider Demographics
NPI:1942799937
Name:BEHLAU MEDICAL PLLC
Entity Type:Organization
Organization Name:BEHLAU MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:IRMGARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHLAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-534-5712
Mailing Address - Street 1:221 CONANT RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1019
Mailing Address - Country:US
Mailing Address - Phone:781-534-5712
Mailing Address - Fax:
Practice Address - Street 1:221 CONANT RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1019
Practice Address - Country:US
Practice Address - Phone:781-534-5712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75971207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty