Organization
SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY POLANSKY MD (PRESIDENT)
(978) 818-6350
Entity
Organization
Contact information
Practice address
1 ORTHOPEDICS DR, 2ND FLOOR, PEABODY, MA 01960-1668
(978) 818-6350
(978) 818-6355
Mailing address
1 ORTHOPEDICS DR, 2ND FLOOR, PEABODY, MA 01960-1668
(978) 818-6350
(978) 818-6355
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9773363
—
MA
01
—
M15814
MEDICARE
MA
Enumeration date
02/01/2012
Last updated
02/01/2012
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