Provider Demographics
NPI:1982742532
Name:PROFESSIONAL MEDICAL ASSOCIATES,P.C.
Entity Type:Organization
Organization Name:PROFESSIONAL MEDICAL ASSOCIATES,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-879-4407
Mailing Address - Street 1:475 FRANKLIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6264
Mailing Address - Country:US
Mailing Address - Phone:508-879-4407
Mailing Address - Fax:508-620-9395
Practice Address - Street 1:475 FRANKLIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6264
Practice Address - Country:US
Practice Address - Phone:508-879-4407
Practice Address - Fax:508-620-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44666208600000X
MA155016208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA614631OtherTUFTS HEALTH PLAN
MA9723005Medicaid
MAM13490OtherBLUE CROSS & BLUE SHIELD
MAM13490Medicare ID - Type UnspecifiedGROUP ID#