Healthcare Provider Details

I. General information

NPI: 1326573189
Provider Name (Legal Business Name): WINCHESTER PHYSICIAN ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 MAIN STREET
TEWSBURY MA
01876
US

IV. Provider business mailing address

2345 MAIN STREET
TEWSBURY MA
01876
US

V. Phone/Fax

Practice location:
  • Phone: 978-658-9931
  • Fax: 978-694-0991
Mailing address:
  • Phone: 978-658-9931
  • Fax: 978-694-0991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: EILEEN WELLS
Title or Position: MANAGER
Credential:
Phone: 781-756-7273