Organization
LINDA H. LEAVENWORTH, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA H LEAVENWORTH M.D. (DIRECT OWNER)
(978) 635-0477
Entity
Organization
Contact information
Practice address
411 MASSACHUSETTS AVE, SUITE 202, ACTON, MA 01720-3739
(978) 635-0477
Mailing address
411 MASSACHUSETTS AVENUE, SUITE 202, ACTON, MA 01720
(978) 635-0477
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
56101
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056101
TUFTS PROVIDER #
MA
01
—
0700573
UNITED HEALTHCARE ID#
MA
01
—
13614
HPHC PROVIDER#
MA
01
—
1938517
CIGNA PROVIDER ID#
MA
01
—
2018428
AETNA PROVIDER #
MD
05
—
3023311
—
MA
01
—
7166
FALLON PROVIDER ID#
MA
01
—
J06513
BCBS INDIVDUAL PROVIDER #
MA
01
—
M16905
BCBS OF MA GRP#
MA
Enumeration date
06/01/2007
Last updated
08/22/2020
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