| Pc Shah Md Inc | |
|
365 Main St Winthrop MA 02152 | |
| (617) 846-5352 | |
| (617) 846-1062 |
| Full Name | Pc Shah Md Inc |
|---|---|
| Speciality | Surgery |
| Location | 365 Main St, Winthrop, Massachusetts |
| Authorized Official Name and Position | Pramodchandra C Shah (PRESIDENT) |
| Authorized Official Contact | 6178465352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pc Shah Md Inc 365 Main St Winthrop MA 02152 Ph: (617) 846-5352 | Pc Shah Md Inc 365 Main St Winthrop MA 02152 Ph: (617) 846-5352 |
| NPI Number | 1760443402 |
|---|---|
| Provider Enumeration Date | 03/31/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1052366846 |
|---|---|
| Medicare Enrollment ID | O20050315000236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760443402 | NPI | - | NPPES |
| 9731342 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208600000X | Surgery | (* (Not Available)) | Primary |
| Provider Name | Pramodchandra C Shah |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316915465 PECOS PAC ID: 9830144625 Enrollment ID: I20060228000209 |
| Provider Name | Jeanne M Holgersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326658790 PECOS PAC ID: 9931469160 Enrollment ID: I20201119002648 |
Commonwealth Primary Care Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 365 Main St, Winthrop, MA 02152 Phone: 617-846-5352 Fax: 617-846-1062 | |
Desai Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 249 Washington Ave, Winthrop, MA 02152 Phone: 617-846-1318 Fax: 617-846-9346 |