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Contact Information

JOHN T MANDEVILLE, M.D., PHD
97 LIBBEY INDUSTRIAL PKWY STE 100
EAST WEYMOUTH, MA02189-3110
 Phone: 781-331-3300
 Fax: 781-337-8356
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Ophthalmic Plastic and Reconstructive Surgery

207WX0200X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for JOHN T MANDEVILLE · (Male)

NPI Number 1811986060
Status Active
Credentials M.D., PHD
Entity Individual
Enumeration date 10/20/2005
Last updated 12/23/2021 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 209475
  • MA Medicaid 0174629
Hospital affiliation(s)
  • SOUTH SHORE HOSPITAL - (Acute Care)
    55 FOGG ROAD
    SOUTH WEYMOUTH, MA 02190
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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