Provider Demographics
NPI:1174364723
Name:MEDFIELD INTERNAL MEDICINE, PLLC
Entity type:Organization
Organization Name:MEDFIELD INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:E
Authorized Official - Last Name:KLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-359-8141
Mailing Address - Street 1:266 MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2018
Mailing Address - Country:US
Mailing Address - Phone:508-359-8141
Mailing Address - Fax:508-359-8005
Practice Address - Street 1:266 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2018
Practice Address - Country:US
Practice Address - Phone:508-359-8141
Practice Address - Fax:508-359-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty