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Organization
WINCHESTER PHYSICIAN ASSOCIATES
Active
Organization
WINCHESTER PHYSICIAN ASSOCIATES
Active
Other names
Mystic Valley Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN WILLS (BILLING MANAGER)
(781) 756-7273
Entity
Organization
Contact information
Practice address
75 RIVERSIDE AVE, 2, MEDFORD, MA 02155-4600
(781) 391-8821
(781) 395-8798
Mailing address
PO BOX 760, WINCHESTER, MA 01890-4260
(781) 756-7273
(781) 756-7274
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
73721
MA
208000000X
Pediatrics Physician
Primary
73788
MA
208000000X
Pediatrics Physician
74993
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9777229
—
MA
Enumeration date
11/28/2005
Last updated
03/20/2008
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