MEDICARE: MRS. JOAN A PETERS-GILMARTIN PA-C

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	363A00000X	Physician Assistant	708	MA
2	363A00000X	Physician Assistant	PA708	MA

General Provider Information

NPI Number	:	1740282730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOAN A PETERS-GILMARTIN PA-C

Provider Business Mailing Address
First Line	:	81 OLD COLONY WAY
Second Line	:	SUITE D
City	:	ORLEANS
State	:	MA
Zip	:	02653-3278
Country	:	US
Telephone Number	:	508-240-1141
Fax Number	:	508-240-3031

Provider Business Practice Location Address
First Line	:	81 OLD COLONY WAY
Second Line	:	SUITE D
City	:	ORLEANS
State	:	MA
Zip	:	02653-3278
Country	:	US
Telephone Number	:	508-240-1141
Fax Number	:	508-240-3031

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/19/2012

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Directions to “ MRS. JOAN A PETERS-GILMARTIN PA-C” Practice Location

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