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NPI Code Detail

MEDICARE: DIGESTIVE DISEASE ASSOCIATES PC

MEDICARE: DIGESTIVE DISEASE ASSOCIATES PC
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
1207R00000XInternal Medicine Physician
2207RG0100XGastroenterology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174700421
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIGESTIVE DISEASE ASSOCIATES PC
Provider Business Mailing Address
First Line : 47 OBERY ST
Second Line : STE 201
City : PLYMOUTH
State : MA
Zip : 02360
Country : US
Telephone Number : 508-747-1560
Fax Number : 508-747-5155
Provider Business Practice Location Address
First Line : 47 OBERY ST
Second Line : STE 201
City : PLYMOUTH
State : MA
Zip : 02360-2230
Country : US
Telephone Number : 508-747-1560
Fax Number : 508-747-5155
Authorized Official
Title or Position : PRESIDENT
Name : DR. JONATHAN M RUSSO
Credential : MD
Telephone Number : 508-747-1560
Provider Enumeration Date : 01/29/2008
Last Update Date : 11/15/2016

Similar Medicare Providers

1770540346 — DR. BRUCE RAYMOND MARCEL MD
Practice Location Address:
47 OBERY ST , STE 201
PLYMOUTH, MA
02360-2230
Practice Phone: 508-747-1560
Practice Fax: 508-747-5155
1427108786 — DR. JOSE C TEIXEIRA-DA-SILVA JR. MD
Practice Location Address:
47 OBERY ST STE 1A
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Practice Phone: 508-747-4883
Practice Fax: 87-476-6615
1285879387 — MS. KAREN V HEBSHIE-BISHOP ANP
Practice Location Address:
47 OBERY ST STE 1A
PLYMOUTH, MA
02360-2230
Practice Phone: 508-747-4883
Practice Fax:
1922550557 — MELISSA WILLETTE NP-C
Practice Location Address:
47 OBERY ST STE 1A
PLYMOUTH, MA
02360-2230
Practice Phone: 508-747-4883
Practice Fax:
1417475260 — JILLIAN JEAN TRIMBLE MSN, CNP, FNP-BC
Practice Location Address:
47 OBERY ST STE 1A
PLYMOUTH, MA
02360-2230
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Practice Fax:
1225667694 — MICHAEL C BALDINO DO
Practice Location Address:
47 OBERY ST STE 1A
PLYMOUTH, MA
02360-2230
Practice Phone: 508-747-4883
Practice Fax: 508-747-6661

Directions to “DIGESTIVE DISEASE ASSOCIATES PC ” Practice Location

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