Organization
MARION PEDIATRICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE CHURCH (BILLING MANAGER)
(508) 996-9333
Entity
Organization
Contact information
Practice address
404 HUTTLESTON AVE, FAIRHAVEN, MA 02719-5630
(508) 996-9333
Mailing address
404 HUTTLESTON AVE, FAIRHAVEN, MA 02719-5630
(508) 996-9333
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000024150
BMC HEALTH NET GROUP #
MA
01
—
680878
TUFTS GROUP #
MA
05
—
97853202
—
MA
01
—
M17252
BCBS OF MA GROUP #
MA
Enumeration date
05/17/2007
Last updated
08/22/2020
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