Individual
AVIS M KOW
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 ESSEX CENTER DR, PEABODY, MA 01960-2902
(978) 977-4000
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8053
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35106
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015275
NEIGHBORHOOD HEALTH
MA
05
—
3083578
—
MA
01
—
794897
TUFTS
MA
01
—
B10452102
CIGNA
MA
01
—
K19122
BLUE CROSS
MA
01
—
PV373
HARVARD PILGRIM
MA
Enumeration date
01/09/2006
Last updated
07/08/2007
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