Organization
CAPE COD PLASTIC & HAND SURGEONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER EDWARD BENTIVEGNA MD (PRESIDENT)
(508) 771-4263
Entity
Organization
Contact information
Practice address
150 ANSEL HALLET RD, SUITE A, WEST YARMOUTH, MA 02673-2582
(508) 771-4263
(508) 771-7906
Mailing address
PO BOX 693, SOUTH YARMOUTH, MA 02664-0693
(508) 771-4263
(508) 771-7906
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
76228
MA
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
76228
MA
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
76228
MA
2086S0122X
Plastic and Reconstructive Surgery Physician
76228
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
614206
TUFTS HEALTH PLANS PAYEE
MA
Enumeration date
02/14/2007
Last updated
11/14/2012
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