MEDICARE: PHYSICIANS OF NORTH WORCESTER COUNTY

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M15501	OTHER	MD	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962536607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS OF NORTH WORCESTER COUNTY

Provider Business Mailing Address
First Line	:	201 HIGHLAND ST
Second Line	:	SUITE 2
City	:	CLINTON
State	:	MA
Zip	:	01510-1037
Country	:	US
Telephone Number	:	978-368-3870
Fax Number	:	978-368-3877

Provider Business Practice Location Address
First Line	:	80 MECHANIC ST
Second Line	:
City	:	ATHOL
State	:	MA
Zip	:	01331-3534
Country	:	US
Telephone Number	:	978-249-7818
Fax Number	:	978-249-4445

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LOURDES BANTING FLAMINIANO
Credential	:	MD
Telephone Number	:	978-368-3870

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	01/24/2013

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Practice Location Address:

80 MECHANIC ST , 1:4
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01331-3534

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Practice Location Address:

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Practice Location Address:

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ATHOL, MA
01331-3534

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Practice Fax: 978-249-5323

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Practice Location Address:

80 MECHANIC ST
ATHOL, MA
01331-3534

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Practice Location Address:

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Directions to “PHYSICIANS OF NORTH WORCESTER COUNTY ” Practice Location

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