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Organization
PHILIP J TAVANO MD PC
Active
Organization
PHILIP J TAVANO MD PC
Active
Other names
merrimack valley internal medicine associates, pc
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP J TAVANO M.D. (PRESIDENT)
(978) 459-2152
Entity
Organization
Contact information
Practice address
20 RESEARCH PL, SUITE 310, N CHELMSFORD, MA 01863-2454
(978) 459-2152
(978) 452-7285
Mailing address
20 RESEARCH PL, SUITE 310, N CHELMSFORD, MA 01863-2454
(978) 459-2152
(978) 452-7285
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42398
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00-00760
EVERCARE
MA
01
—
1043245145
NPI
—
01
—
1205861390
NPI
—
01
—
1710919238
NPI
—
01
—
702916
TUFTS HEALTH PLAN
MA
05
—
9719741
—
MA
01
—
PHM13259
BLUE SHIELD OF MA
MA
Enumeration date
08/13/2006
Last updated
04/10/2008
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