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NPI Code Detail

MEDICARE: MR. MATTHEW J ENOS PA

MEDICARE: MR. MATTHEW J ENOS PA
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
1363AM0700XMedical Physician Assistant1739MA

General Provider Information

NPI Number : 1962577262
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW J ENOS PA
Provider Business Mailing Address
First Line : 57 CITY HALL AVE
Second Line :
City : GARDNER
State : MA
Zip : 01440-2614
Country : US
Telephone Number : 978-630-3862
Fax Number : 978-630-4176
Provider Business Practice Location Address
First Line : 57 CITY HALL AVE
Second Line :
City : GARDNER
State : MA
Zip : 01440-2614
Country : US
Telephone Number : 978-630-3862
Fax Number : 978-630-4176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 07/08/2007

Similar Medicare Providers

1467427708 — JENNIFER RYAN D.O.
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
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1386610863 — AMANDA SPADAZZI M.D.
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1730225582 — DR. JEFFREY D MOSER D.P.M.
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57 CITY HALL AVE
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01440-2614
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Practice Fax:
1003011594 — GARDNER FAMILY MEDICINE, INC.
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
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Practice Fax: 978-630-4176
1992201925 — ERIK WILLIAM WISNIEWSKI FNP
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
Practice Phone: 978-630-3862
Practice Fax:
1104541432 — MISS CHELSEA LEE GAGNE FNP-C
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
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Practice Fax: 978-630-4176

Directions to “ MR. MATTHEW J ENOS PA” Practice Location

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