Provider Demographics
NPI:1811987720
Name:TAUNTON MEDICAL CENTER, PC
Entity type:Organization
Organization Name:TAUNTON MEDICAL CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CATICHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-821-2500
Mailing Address - Street 1:PO BOX 9132
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-9132
Mailing Address - Country:US
Mailing Address - Phone:800-927-0002
Mailing Address - Fax:603-890-1236
Practice Address - Street 1:54 COURT ST
Practice Address - Street 2:TAUNTON MEDICAL CENTER
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3201
Practice Address - Country:US
Practice Address - Phone:508-821-2500
Practice Address - Fax:508-821-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9703501Medicaid
MAM20835Medicare ID - Type Unspecified