Classic Healthcare Medical Group Llc | |
300 Chestnut St Ste 1400 Needham MA 02492-2497 | |
(781) 559-0230 | |
(781) 559-0231 |
Full Name | Classic Healthcare Medical Group Llc |
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Speciality | Internal Medicine |
Location | 300 Chestnut St, Needham, Massachusetts |
Authorized Official Name and Position | Steven Van Dam (MEDICAL DIRECTOR) |
Authorized Official Contact | 7815590230 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Classic Healthcare Medical Group Llc 300 Chestnut St Ste 1400 Needham MA 02492-2497 Ph: (781) 559-0230 | Classic Healthcare Medical Group Llc 300 Chestnut St Ste 1400 Needham MA 02492-2497 Ph: (781) 559-0230 |
NPI Number | 1649691957 |
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Provider Enumeration Date | 01/05/2014 |
Last Update Date | 01/05/2014 |
Medicare PECOS PAC ID | 4688806003 |
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Medicare Enrollment ID | O20140416001866 |
Identifier | Type | State | Issuer |
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1649691957 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | 205080 (Massachusetts) | Primary |
Provider Name | Steven Van Dam |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1447206214 PECOS PAC ID: 8123001492 Enrollment ID: I20040608001240 |
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