| Bespoke Primary Care, PLLC | |
|
60 Walnut St Bsmt Wellesley MA 02481-2151 | |
| (617) 531-9503 | |
| Not Available |
| Full Name | Bespoke Primary Care, PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 60 Walnut St Bsmt, Wellesley, Massachusetts |
| Authorized Official Name and Position | Michael Richardson (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6175319503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bespoke Primary Care, PLLC 60 Walnut St Bsmt Wellesley MA 02481-2151 Ph: (617) 531-9503 | Bespoke Primary Care, PLLC 60 Walnut St Bsmt Wellesley MA 02481-2151 Ph: (617) 531-9503 |
| NPI Number | 1396617114 |
|---|---|
| Provider Enumeration Date | 09/22/2025 |
| Last Update Date | 09/22/2025 |
| Certification Date | 09/22/2025 |
| Medicare PECOS PAC ID | 6608357959 |
|---|---|
| Medicare Enrollment ID | O20260225000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396617114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Michael Richardson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124430160 PECOS PAC ID: 6901191675 Enrollment ID: I20170714000899 |
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