MEDICARE: GREATER LOWELL OB-GYN, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	M16293	OTHER	MA	BCBS

General Provider Information

NPI Number	:	1053337196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER LOWELL OB-GYN, INC

Provider Business Mailing Address
First Line	:	505 NASHUA RD STE 7
Second Line	:	DRACUT MEDICAL CENTER
City	:	DRACUT
State	:	MA
Zip	:	01826-1929
Country	:	US
Telephone Number	:	978-957-9577
Fax Number	:	978-957-6900

Provider Business Practice Location Address
First Line	:	505 NASHUA RD STE 7
Second Line	:	DRACUT MEDICAL CENTER
City	:	DRACUT
State	:	MA
Zip	:	01826-1929
Country	:	US
Telephone Number	:	978-957-9577
Fax Number	:	978-957-6900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NAVIN POPAT
Credential	:	M.D.
Telephone Number	:	978-957-9577

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	08/22/2020

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