Healthcare Provider Details

I. General information

NPI: 1356347405
Provider Name (Legal Business Name): CURTIS P ERSING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 COUNTY RD
IPSWICH MA
01938-2585
US

IV. Provider business mailing address

299 ESSEX ST
BEVERLY MA
01915-1918
US

V. Phone/Fax

Practice location:
  • Phone: 978-356-1192
  • Fax: 978-356-9943
Mailing address:
  • Phone: 978-922-2674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number73794
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: