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NPI Code Detail

MEDICARE: ELISABETH BEATRICE WINTERKORN MD

MEDICARE: ELISABETH BEATRICE WINTERKORN MD
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
1208000000XPediatrics Physician222508MA

General Provider Information

NPI Number : 1184615957
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISABETH BEATRICE WINTERKORN MD
Provider Business Mailing Address
First Line : 4 PLACE LN
Second Line :
City : WOBURN
State : MA
Zip : 01801-2928
Country : US
Telephone Number : 781-935-7614
Fax Number :
Provider Business Practice Location Address
First Line : 477 ANDOVER ST
Second Line : CHILDREN'S MEDICAL OFFICE OF NORTH ANDOVER
City : NORTH ANDOVER
State : MA
Zip : 01845-5036
Country : US
Telephone Number : 978-975-3355
Fax Number : 978-975-3510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 07/08/2007

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