| Norfolk Gastroenterology, Pc | |
|
31 Pine St Suite # 300 Norfolk MA 02056-1642 | |
| (508) 623-3700 | |
| (508) 623-3701 |
| Full Name | Norfolk Gastroenterology, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 31 Pine St, Norfolk, Massachusetts |
| Authorized Official Name and Position | Derek Frederickson (PRESIDENT) |
| Authorized Official Contact | 5086233700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Norfolk Gastroenterology, Pc 31 Pine St Suite # 300 Norfolk MA 02056-1642 Ph: (508) 623-3700 | Norfolk Gastroenterology, Pc 31 Pine St Suite # 300 Norfolk MA 02056-1642 Ph: (508) 623-3700 |
| NPI Number | 1306221981 |
|---|---|
| Provider Enumeration Date | 07/24/2015 |
| Last Update Date | 07/28/2015 |
| Medicare PECOS PAC ID | 7416265152 |
|---|---|
| Medicare Enrollment ID | O20150930001261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306221981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Derek Frederickson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518184514 PECOS PAC ID: 4789758616 Enrollment ID: I20080811000323 |
Pondville Medical Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 31 Pine St, Norfolk, MA 02056 Phone: 508-623-3700 |