Healthcare Provider Details

I. General information

NPI: 1437104205
Provider Name (Legal Business Name): MEDICAL ANESTHESIOLOGY CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 NICHOLS RD SUITE 16
FITCHBURG MA
01420-1914
US

IV. Provider business mailing address

PO BOX 3008
LEWISTON ME
04243-3008
US

V. Phone/Fax

Practice location:
  • Phone: 978-665-5800
  • Fax: 978-665-5802
Mailing address:
  • Phone: 800-720-1664
  • Fax: 207-753-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MARGE WINTERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 978-665-5800