Provider Demographics
NPI:1841508165
Name:SOUTHEAST RHEUMATOLOGY & IMMUNOLOGY, LLC
Entity type:Organization
Organization Name:SOUTHEAST RHEUMATOLOGY & IMMUNOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:I
Authorized Official - Last Name:SPERLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-828-4511
Mailing Address - Street 1:263 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SHERBORN
Mailing Address - State:MA
Mailing Address - Zip Code:01770-1019
Mailing Address - Country:US
Mailing Address - Phone:508-828-4511
Mailing Address - Fax:508-828-4512
Practice Address - Street 1:72 WASHINGTON ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2491
Practice Address - Country:US
Practice Address - Phone:508-828-4511
Practice Address - Fax:508-828-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53669207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty