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General NPI Number Information
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NPI Number | 1114334422
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Entity Type | Organization
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Legal Business Name | SYNERGY SURGICALISTS LLC
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Dates
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Enumeration Date | 07/18/2014
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 300A FAUNCE CORNER RD
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City | NORTH DARTMOUTH
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State | MA
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Zip | 02747-1280
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Country | US
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Telephone | 508-973-2211
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Fax | 508-973-1105
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Provider Business Mailing Address
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Address Line | PO BOX 843524
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City | DALLAS
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State | TX
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Zip | 75284-3524
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | RICHARD MAKOWIEC
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Credential | MD
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Telephone | 773-425-3562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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