Igc Iii Pllc | |
41 Wellman St Ste 400 Lowell MA 01851-5161 | |
(978) 459-6737 | |
(855) 818-1869 |
Full Name | Igc Iii Pllc |
---|---|
Speciality | Internal Medicine |
Location | 41 Wellman St Ste 400, Lowell, Massachusetts |
Authorized Official Name and Position | Richard S Tilson (CEO) |
Authorized Official Contact | 9784596737 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Igc Iii Pllc 41 Wellman St Ste 400 Lowell MA 01851-5161 Ph: (978) 459-6737 | Igc Iii Pllc 41 Wellman St Ste 400 Lowell MA 01851-5161 Ph: (978) 459-6737 |
NPI Number | 1053010694 |
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Provider Enumeration Date | 03/02/2023 |
Last Update Date | 01/08/2025 |
Medicare PECOS PAC ID | 6305285032 |
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Medicare Enrollment ID | O20240415001992 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053010694 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Richard S Tilson |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1346336831 PECOS PAC ID: 4385605906 Enrollment ID: I20041026000682 |
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