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General NPI Number Information
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NPI Number | 1447830401
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Entity Type | Organization
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Legal Business Name | NORTHSHORE WEIGHT AND METABOLISM, LLC
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 110 HAVERHILL RD STE 200
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City | AMESBURY
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State | MA
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Zip | 01913-2119
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Country | US
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Telephone | 978-473-3221
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Fax |
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Provider Business Mailing Address
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Address Line | 110 HAVERHILL RD STE 505
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City | AMESBURY
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State | MA
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Zip | 01913-2150
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Country | US
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Telephone | 978-473-3221
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | DANIELLE PETERSON
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Credential |
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Telephone | 978-473-3221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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