Organization
FITCHBURG ADULT MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND EDWARD WOLEJKO MD (MANAGING PARTNER)
(978) 342-6018
Entity
Organization
Contact information
Practice address
76 SUMMER ST, SUITE 230, FITCHBURG, MA 01420-5783
(978) 342-6018
(978) 343-4281
Mailing address
76 SUMMER ST, SUITE 230, FITCHBURG, MA 01420-5783
(978) 342-6018
(978) 343-4281
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
45633
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003445
MEDICARE PTAN
MA
05
—
9709029
—
MA
Enumeration date
03/15/2007
Last updated
01/28/2008
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