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NPI Code Detail

MEDICARE: DR. CRAIG STEWART TENZER D.P.M.

MEDICARE: DR. CRAIG STEWART TENZER D.P.M.
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
1213E00000XPodiatristPD 1980MA
2213EP1101XPrimary Podiatric Medicine PodiatristPD 1980MA
3213ER0200XRadiology PodiatristPD 1980MA
4213ES0000XSports Medicine PodiatristPD 1980MA
5213ES0103XFoot & Ankle Surgery PodiatristPD 1980MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1043282327OTHERMATAX IDENTIFICATION NUMBER
2Y70957OTHERMABLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number : 1346231453
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRAIG STEWART TENZER D.P.M.
Provider Business Mailing Address
First Line : 166 CANNON FORGE DR
Second Line :
City : FOXBORO
State : MA
Zip : 02035-5212
Country : US
Telephone Number : 617-620-9758
Fax Number : 508-698-9950
Provider Business Practice Location Address
First Line : 235 HANOVER ST
Second Line :
City : FALL RIVER
State : MA
Zip : 02720-5246
Country : US
Telephone Number : 617-620-9758
Fax Number : 508-698-9950
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 09/15/2011

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