Organization
MERRIMACK VALLEY MEDICAL ASSOCIATES, PC
Active
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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