Organization
ST JOHNS EMERGENCY ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER N GORLIN MD (PRES)
(978) 453-3022
Entity
Organization
Contact information
Practice address
1 HOSPITAL DR, SAINTS MEDICAL CENTER, LOWELL, MA 01852
(978) 458-1411
(978) 453-9330
Mailing address
1230 BRIDGE ST, LOWELL, MA 01850
(978) 453-3022
(978) 453-9330
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9784713
—
MA
01
—
M17128
BLUE SHIELD
MA
Enumeration date
11/20/2006
Last updated
08/22/2020
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