Healthcare Provider Details

I. General information

NPI: 1073287488
Provider Name (Legal Business Name): ADULT PRIMARY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 MAIN ST STE 3B
NORTH READING MA
01864-2286
US

IV. Provider business mailing address

21 MAIN ST STE 2A
NORTH READING MA
01864-2286
US

V. Phone/Fax

Practice location:
  • Phone: 978-664-4600
  • Fax: 888-487-9741
Mailing address:
  • Phone: 978-664-4600
  • Fax: 888-487-9741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VASANT R PATEL
Title or Position: PHYSICIAN
Credential: MD
Phone: 781-883-2962