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MERRIMACK FAMILY MEDICINE PC NPI 1033392022


NPI Information

NPI: 1033392022
Provider Name: MERRIMACK FAMILY MEDICINE PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 22D2022107

Address:
170 MAIN STREET
SUITE 606
TEWKSBURY, MA
ZIP 01876
Phone: (978) 851-4141
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MERRIMACK FAMILY MEDICINE PC is a family medicine in Tewksbury, MA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MERRIMACK FAMILY MEDICINE PC NPI is 1033392022. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

170 MAIN STREET
SUITE 606
TEWKSBURY, MA
ZIP 01876
Phone: (978) 851-4141

The provider's authorized official is Donald H Miller .
The authorized official title is President and has the following contact phone number (978) 851-4141.

The CLIA number assigned to this NPI record is 22D2022107 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/12/2007 and was last updated on 12/12/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine49826MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19763473MEDICAIDMASSACHUSETTS
2B97873MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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