Basic Information
| Provider Information | |||||||||
| NPI: | 1164694956 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OCEAN MEDICAL SYSTEMS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 HOLLY HILL CIR | ||||||||
| Address2: | |||||||||
| City: | MARSHFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020501728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818375900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 90 LIBBEY INDUSTRIAL PKWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021893130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816244950 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2008 | ||||||||
| LastUpdateDate: | 04/01/2008 | ||||||||
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| AuthorizedOfficialLastName: | BURAS | ||||||||
| AuthorizedOfficialFirstName: | WENDE | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | GENERAL PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7818375900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.