Healthcare Provider Details

I. General information

NPI: 1033160288
Provider Name (Legal Business Name): OB-GYN WOMEN'S CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 ANDOVER ST SUITE 335
N ANDOVER MA
01845-5044
US

IV. Provider business mailing address

451 ANDOVER ST SUITE 335
N ANDOVER MA
01845-5044
US

V. Phone/Fax

Practice location:
  • Phone: 978-688-9979
  • Fax: 978-688-7727
Mailing address:
  • Phone: 978-688-9979
  • Fax: 978-688-7727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number152673
License Number StateMA

VIII. Authorized Official

Name: MARIE C LEMONNIER
Title or Position: MD
Credential: MD
Phone: 978-688-9979