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General NPI Number Information
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NPI Number | 1578552964
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Entity Type | Organization
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Legal Business Name | CENTRAL MA CARDIOVASCULAR PHYSICIANS INC
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 198 GROTON ROAD STE 4
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City | AYER
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State | MA
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Zip | 01432
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Country | US
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Telephone | 978-772-5755
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Fax | 978-772-1611
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Provider Business Mailing Address
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Address Line | 198 GROTON ROAD STE 4
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City | AYER
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State | MA
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Zip | 01432
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Country | US
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Telephone | 978-772-5755
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Fax | 978-772-1611
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADAM W CEREL
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Credential | MD
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Telephone | 978-772-5755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 72365
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License Number State | MA
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