Healthcare Provider Details

I. General information

NPI: 1932326949
Provider Name (Legal Business Name): FALMOUTH PEDIATRIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 BRAMBLEBUSH PARK
FALMOUTH MA
02540-2325
US

IV. Provider business mailing address

2 BRAMBLEBUSH PARK
FALMOUTH MA
02540
US

V. Phone/Fax

Practice location:
  • Phone: 508-540-1801
  • Fax: 508-540-6595
Mailing address:
  • Phone: 508-540-1801
  • Fax: 508-540-6595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER T. LIND
Title or Position: MEDICAL PHYSICIAN
Credential: M.D.
Phone: 508-540-1801