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General NPI Number Information
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NPI Number | 1992881437
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Entity Type | Organization
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Legal Business Name | TRUESDALE MEDICAL PARTNERS, LLC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 1030 PRESIDENT AVE
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City | FALL RIVER
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State | MA
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Zip | 02720-5923
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Country | US
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Telephone | 508-676-3411
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 PRESIDENT AVE
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City | FALL RIVER
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State | MA
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Zip | 02720-5923
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Country | US
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Telephone | 508-676-3411
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES EIL
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Credential |
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Telephone | 508-676-3411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 14286
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1715
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License Number State | MA
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