Provider Demographics
NPI:1912095308
Name:NATOV MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:NATOV MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SVETLOZAR
Authorized Official - Middle Name:NIKOLOV
Authorized Official - Last Name:NATOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:339-499-1058
Mailing Address - Street 1:851 MAIN ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1612
Mailing Address - Country:US
Mailing Address - Phone:339-499-1058
Mailing Address - Fax:339-499-1078
Practice Address - Street 1:851 MAIN ST
Practice Address - Street 2:SUITE 10
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1612
Practice Address - Country:US
Practice Address - Phone:339-499-1058
Practice Address - Fax:339-499-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15233174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MADD9432OtherRAIL ROAD MEDICARE
MAM21712Medicare PIN