Healthcare Provider Details
I. General information
NPI: 1497671374
Provider Name (Legal Business Name): INTEGRATED GASTROENTEROLOGY CONSULTANTS SEACOAST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
325 LAFAYETTE RD
SEABROOK NH
03874-4561
US
IV. Provider business mailing address
41 WELLMAN ST STE 400
LOWELL MA
01851-5161
US
V. Phone/Fax
- Phone: 978-459-6737
- Fax:
- Phone: 978-478-6737
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICHARD
TILSON
Title or Position: OWNER
Credential: MD
Phone: 978-458-6737