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General NPI Number Information
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NPI Number | 1881652758
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Entity Type | Individual
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Provider Name | MARK C. NITZBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 11/16/2017
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Provider Practice Location Address
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Address Line | 38R MERRIMACK ST. SUITE 2C
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City | METHUEN
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State | MA
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Zip | 01844
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Country | US
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Telephone | 978-681-1977
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Fax | 978-686-8918
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Provider Business Mailing Address
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Address Line | 380R MERRIMACK ST. SUITE 2C
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City | METHUEN
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State | MA
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Zip | 01844
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Country | US
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Telephone | 978-681-1977
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Fax | 978-686-8918
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 74584
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License Number State | MA
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