Healthcare Provider Details

I. General information

NPI: 1154591782
Provider Name (Legal Business Name): NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 HOSPITAL AVE
NORTH ADAMS MA
01247-2504
US

IV. Provider business mailing address

71 HOSPITAL AVE
NORTH ADAMS MA
01247-2504
US

V. Phone/Fax

Practice location:
  • Phone: 413-664-4343
  • Fax: 413-664-7320
Mailing address:
  • Phone: 413-664-4343
  • Fax: 413-664-7320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CALWAY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 413-664-5508