MEDICARE: MDINTERACTIVE HEALTH PLLC

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1336076520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MDINTERACTIVE HEALTH PLLC

Provider Business Mailing Address
First Line	:	48 PONDVIEW RD
Second Line	:
City	:	SUDBURY
State	:	MA
Zip	:	01776-2542
Country	:	US
Telephone Number	:	800-634-4731
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 PONDVIEW RD
Second Line	:
City	:	SUDBURY
State	:	MA
Zip	:	01776-2542
Country	:	US
Telephone Number	:	800-634-4731
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. PAULO ANDRE
Credential	:	MD
Telephone Number	:	800-634-4731

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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