Mudrock, John David
Mudrock, John David is an sole proprietor health care provider with primary practice located at 888 Main St Ste 101 , Wakefield MA 01880-4080. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mudrock, John David can be contacted via phone (781) 620-4888.Contact Information
Primary practice address
888 Main St Ste 101
Wakefield MA 01880-4080
Phone: (781) 620-4888
Fax: (781) 245-2602
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 44046 | Massachusetts |
Profile Details
| NPI number | 1780675751 |
|---|---|
| LBN Legal business name | Mudrock, John David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Feb 19th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780675751 | NPPES |
| Massachusetts | MEDICAID | 0129704 |
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