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General NPI Number Information
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NPI Number | 1689875288
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Entity Type | Organization
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Legal Business Name | CARDIO - THORACIC & VASCULAR SURGERY INC
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 2 MEDICAL CENTER DR SUITE 104
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City | SPRINGFIELD
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State | MA
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Zip | 01107
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Country | US
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Telephone | 413-737-4715
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Fax | 413-737-4875
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Provider Business Mailing Address
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Address Line | 2 MEDICAL CENTER DR SUITE 104
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City | SPRINGFIELD
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State | MA
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Zip | 01107
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Country | US
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Telephone | 413-737-4715
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Fax | 413-737-4875
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Authorized Official
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Title or Position | DOCTOR
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Name | MARK M SHERMAN
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Credential | MD
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Telephone | 413-737-4715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 36381
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License Number State | MA
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