Provider Demographics
NPI:1992844179
Name:MPD MEDICAL ASSOCIATES MA PC
Entity Type:Organization
Organization Name:MPD MEDICAL ASSOCIATES MA PC
Other - Org Name:REPRODUCTIVE SCIENCE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:GARBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-674-1215
Mailing Address - Street 1:ONE FORBES ROAD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7305
Mailing Address - Country:US
Mailing Address - Phone:781-674-1200
Mailing Address - Fax:781-674-1510
Practice Address - Street 1:ONE FORBES ROAD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7305
Practice Address - Country:US
Practice Address - Phone:781-674-1200
Practice Address - Fax:781-674-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty