Organization
CANAN AVUNDUK, MD. PHD
Active
Other names
Bay State Gastroenterology, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
CATHLEEN DUNN (PHYSICIAN ACCOUNT REPRESENTATIVE)
(781) 979-6366
Entity
Organization
Contact information
Practice address
536 LEBANON ST, MELROSE, MA 02176-3523
(781) 979-0286
(781) 979-0324
Mailing address
1715 BROADWAY, SAUGUS, MA 01906-4703
(781) 979-6370
(781) 979-6373
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
46084
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6175864
—
MA
01
—
683460
TUFTS PROVIDER NUMBER
—
01
—
M17346
BLUE SHIELD PROVIDER NUMBER
—
Enumeration date
06/24/2008
Last updated
06/24/2008
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