Healthcare Provider Details

I. General information

NPI: 1487840849
Provider Name (Legal Business Name): ABC PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 TURNPIKE ST STE 28
NORTH ANDOVER MA
01845-5937
US

IV. Provider business mailing address

575 TURNPIKE ST STE 28
NORTH ANDOVER MA
01845-5937
US

V. Phone/Fax

Practice location:
  • Phone: 978-686-6957
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SUNANTA L. OBER
Title or Position: OWNER
Credential: M.D.
Phone: 978-686-6957