MEDICARE: WINCHESTER PHYSICIAN ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	52807	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063495455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINCHESTER PHYSICIAN ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 760
Second Line	:
City	:	WINCHESTER
State	:	MA
Zip	:	01890-4260
Country	:	US
Telephone Number	:	781-756-7273
Fax Number	:	781-756-7274

Provider Business Practice Location Address
First Line	:	3 WOODLAND RD
Second Line	:	213
City	:	STONEHAM
State	:	MA
Zip	:	02180-1702
Country	:	US
Telephone Number	:	781-662-7990
Fax Number	:	781-665-0391

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	ANGELA LEUNG
Credential	:
Telephone Number	:	781-756-7273

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	08/22/2020

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Directions to “WINCHESTER PHYSICIAN ASSOCIATES ” Practice Location

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