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General NPI Number Information
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NPI Number | 1083845721
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Entity Type | Organization
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Legal Business Name | BETSY S AUGUST MD LLC
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 55 HIGHLAND AVE STE 103
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City | SALEM
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State | MA
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Zip | 01970-2100
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Country | US
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Telephone | 978-741-2500
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Fax | 978-741-1146
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Provider Business Mailing Address
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Address Line | 55 HIGHLAND AVE STE 103
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City | SALEM
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State | MA
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Zip | 01970-2100
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Country | US
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Telephone | 978-741-2500
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Fax | 978-741-1146
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | KATHLEEN FITZGERALD
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Credential |
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Telephone | 508-581-9865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 59447
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License Number State | MA
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