| Mass Medical Group, Llc | |
|
200 Central St Suite #2 Lowell MA 01852-2201 | |
| (978) 446-7982 | |
| (866) 897-3951 |
| Full Name | Mass Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 Central St, Lowell, Massachusetts |
| Authorized Official Name and Position | Hamid Reza Danesh (MEMBER) |
| Authorized Official Contact | 9788883147 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mass Medical Group, Llc 200 Central St Unit 2 Lowell MA 01852-2201 Ph: (978) 446-7982 | Mass Medical Group, Llc 200 Central St Suite #2 Lowell MA 01852-2201 Ph: (978) 446-7982 |
| NPI Number | 1205215373 |
|---|---|
| Provider Enumeration Date | 05/22/2015 |
| Last Update Date | 09/07/2016 |
| Medicare PECOS PAC ID | 3173815511 |
|---|---|
| Medicare Enrollment ID | O20160706000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205215373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 223435 (Massachusetts) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | 223435 (Massachusetts) | Secondary |
| Provider Name | Hamid R Danesh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811961196 PECOS PAC ID: 3779517321 Enrollment ID: I20050922000710 |
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