Provider Demographics
NPI:1366554776
Name:MELINDA G. RABOIN, MD, PC
Entity type:Organization
Organization Name:MELINDA G. RABOIN, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:RABOIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-692-1222
Mailing Address - Street 1:506 GROTON RD
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-6307
Mailing Address - Country:US
Mailing Address - Phone:978-692-1222
Mailing Address - Fax:978-692-1322
Practice Address - Street 1:506 GROTON RD
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-6307
Practice Address - Country:US
Practice Address - Phone:978-692-1222
Practice Address - Fax:978-692-1322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75223207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
M20681Medicare ID - Type UnspecifiedMEICARE GROUP NUMBER