Organization
MERRIMACK VALLEY MEDICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEO WILLIAM LANE D.O. (OWNER)
(978) 725-4822
Entity
Organization
Contact information
Practice address
421 MERRIMACK ST, SUITE 201, METHUEN, MA 01844-5803
(978) 725-4822
(978) 725-5277
Mailing address
PO BOX 3160, ANDOVER, MA 01810-0803
(978) 289-1188
(978) 474-8845
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
155341
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
155341
TUFTS
MA
01
—
2301962
AETNA US HEALTH
MA
05
—
3208621
—
MA
01
—
49241
FALLON
MA
01
—
504290
CIGNA HEALTHSOURCE
MA
01
—
50493
MATTHEW THORNTON
MA
01
—
69499
HARVARD PILGRIM
MA
01
—
9593735010
CIGNA
MA
01
—
M18024
BLUE CROSS BLUE SHIELD
MA
Enumeration date
09/27/2005
Last updated
09/28/2021
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