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General NPI Number Information
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NPI Number | 1003507013
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Entity Type | Organization
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Legal Business Name | COASTAL ORTHOPEDIC ASSOCIATES INC
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 99 CONIFER HILL DR STE 204
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City | DANVERS
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State | MA
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Zip | 01923-1194
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Country | US
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Telephone | 978-927-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 152 CONANT ST STE 301
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City | BEVERLY
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State | MA
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Zip | 01915-1659
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Country | US
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Telephone | 978-927-3040
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Fax |
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Authorized Official
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Title or Position | COO
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Name | KRISTEN CUTLER
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Credential |
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Telephone | 978-927-3040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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