Organization
BEVERLY SURGICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE P KACOYANIS MD (PRESIDENT)
(978) 927-4004
Entity
Organization
Contact information
Practice address
75 HERRICK ST, SUITE 201, BEVERLY, MA 01915
(978) 927-4004
(978) 922-6640
Mailing address
75 HERRICK ST, SUITE 201, BEVERLY, MA 01915
(978) 927-4004
(978) 922-6640
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9700609
—
MA
Enumeration date
10/02/2006
Last updated
04/10/2013
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