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General NPI Number Information
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NPI Number | 1518938190
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Entity Type | Organization
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Legal Business Name | PILGRIM MEDICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 400 W CUMMINGS PARK SUITE 1825
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City | WOBURN
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State | MA
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Zip | 01801-6519
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Country | US
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Telephone | 781-820-9732
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Fax | 781-989-9396
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Provider Business Mailing Address
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Address Line | 400 W CUMMINGS PARK SUITE 1825
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City | WOBURN
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State | MA
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Zip | 01801-6519
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Country | US
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Telephone | 781-820-9732
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Fax | 781-989-9396
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS WILDER STINSON III
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Credential | M.D.
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Telephone | 781-396-1002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number | 39897
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 39897
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License Number State | MA
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