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NORTHSHORE PLASTIC SURGERY LLC NPI 1548268535


NPI Information

NPI: 1548268535
Provider Name: NORTHSHORE PLASTIC SURGERY, LLC
Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
4 CENTENNIAL DR
STE 102
PEABODY, MA
ZIP 01960
Phone: (978) 531-6966
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NORTHSHORE PLASTIC SURGERY, LLC is a plastic and reconstructive surgery surgery in Peabody, MA. The provider is a surgeon who specializes in plastic and reconstructive surgery. NORTHSHORE PLASTIC SURGERY, LLC NPI is 1548268535. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4 CENTENNIAL DR
STE 102
PEABODY, MA
ZIP 01960-935
Phone: (978) 531-6966
Fax: (978) 531-2221

The provider's authorized official is David J Wages .
The authorized official title is President and has the following contact phone number (978) 531-6966.

The enumeration date for this NPI number is 7/13/2005 and was last updated on 8/22/2020.


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
12086S0122XSurgeryPlastic and Reconstructive Surgery=========MASSACHUSETTSYes

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
19707573MEDICAIDMASSACHUSETTS

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: 11/14/2023

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