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NPI Code Detail

MEDICARE: ANN L ELDRIDGE MD PC

MEDICARE: ANN L ELDRIDGE MD PC
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
1207N00000XDermatology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1M16320OTHERMABC / BS

General Provider Information

NPI Number : 1174719488
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANN L ELDRIDGE MD PC
Provider Business Mailing Address
First Line : 60 MUNSON MEETING WAY STE K
Second Line :
City : CHATHAM
State : MA
Zip : 02633-1992
Country : US
Telephone Number : 508-945-0022
Fax Number : 508-945-1930
Provider Business Practice Location Address
First Line : 60 MUNSON MEETING WAY STE K
Second Line :
City : CHATHAM
State : MA
Zip : 02633-1992
Country : US
Telephone Number : 508-945-0022
Fax Number : 508-945-1930
Authorized Official
Title or Position : PRESIDENT
Name : ANN L ELDRIDGE
Credential : M.D.
Telephone Number : 508-945-0022
Provider Enumeration Date : 09/20/2007
Last Update Date : 09/20/2007

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Directions to “ANN L ELDRIDGE MD PC ” Practice Location

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