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NPI Code Detail

MEDICARE: ATLANTIC PRIMARY CARE, PC

MEDICARE: ATLANTIC PRIMARY CARE, 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
1261QP2300XPrimary Care Clinic/Center79640MA

Other Identifiers

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

General Provider Information

NPI Number : 1326015454
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATLANTIC PRIMARY CARE, PC
Provider Business Mailing Address
First Line : PO BOX 2302
Second Line :
City : HANOVER
State : MA
Zip : 02339-8301
Country : US
Telephone Number : 781-871-5030
Fax Number : 781-871-5480
Provider Business Practice Location Address
First Line : 135 WEBSTER ST
Second Line :
City : HANOVER
State : MA
Zip : 02339-1200
Country : US
Telephone Number : 781-871-5030
Fax Number : 781-871-5480
Authorized Official
Title or Position : PRESIDENT
Name : DR. NAHID B KENNEDY
Credential : D.O.
Telephone Number : 781-871-5030
Provider Enumeration Date : 03/07/2006
Last Update Date : 09/01/2011

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Directions to “ATLANTIC PRIMARY CARE, PC ” Practice Location

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