# MARTHAS VINEYARD EAR NOSE AND THROAT SPECIALISTS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386344331
- **Authorized official:** EDWARD CALDWELL MD (PRESIDENT)
- **Authorized official phone:** (508) 648-9468

## Contact information

- **Practice address:** 20 INDIAN HILL RD, WEST TISBURY, MA 02575
- **Practice address phone:** (508) 367-7131
- **Mailing address:** 60 MEETING HOUSE RD, CHILMARK, MA 02535-2517
- **Mailing address phone:** (508) 648-9468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0012X | Sleep Medicine (Otolaryngology) Physician | — | NULL | — |
| 207YS0012X | Sleep Medicine (Otolaryngology) Physician | — | — | — |
| 207YS0123X | Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YS0123X | Facial Plastic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2023
- **Last updated:** 03/08/2023