Organization
NEW ENGLAND NEUROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILTON DOUGLAS CHILDRESS M.D. (OWNER)
(781) 934-9741
Entity
Organization
Contact information
Practice address
20 TREMONT ST, BLDG 9, SUITE 20, DUXBURY, MA 02332-5310
(781) 934-9741
(781) 934-9783
Mailing address
20 TREMONT ST, BLDG 9, SUITE 20, DUXBURY, MA 02332-5310
(781) 934-9741
(781) 934-9783
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9711520
—
MA
01
—
M17928
BCBS GROUP NUMBER
MA
Enumeration date
03/07/2007
Last updated
08/22/2020
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