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General NPI Number Information
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NPI Number | 1073501649
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Entity Type | Organization
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Legal Business Name | FRANK X. PEDLOW JR, MD PC
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 30 LANCASTER ST 2ND FLR
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City | BOSTON
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State | MA
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Zip | 02114-1704
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Country | US
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Telephone | 617-227-9300
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Fax | 617-227-3800
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Provider Business Mailing Address
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Address Line | PO BOX 86
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City | HINGHAM
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State | MA
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Zip | 02043-0086
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Country | US
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Telephone | 781-749-9071
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Fax | 781-749-2133
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Authorized Official
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Title or Position | OWNER
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Name | FRANK X PEDLOW JR.
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Credential | M.D.
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Telephone | 617-227-9300
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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 | 79694
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License Number State | MA
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