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General NPI Number Information
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NPI Number | 1699958009
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Entity Type | Organization
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Legal Business Name | GI CLINIC PC
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 700 ATTUCKS LN SUITE 1D
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City | HYANNIS
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State | MA
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Zip | 02601-1809
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Country | US
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Telephone | 508-771-6080
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Fax | 508-771-6082
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Provider Business Mailing Address
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Address Line | 700 ATTUCKS LN SUITE 1D
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City | HYANNIS
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State | MA
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Zip | 02601-1809
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Country | US
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Telephone | 508-771-6080
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Fax | 508-771-6082
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEXANDRE K NADER
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Credential | M.D.
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Telephone | 508-771-6080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 154801
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License Number State | MA
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