Organization
CYTODX PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER MICHAEL MCNICHOLAS (ADMINISTRATOR)
(978) 548-5204
Entity
Organization
Contact information
Practice address
200 CORPORATE PL, SUITE #8, PEABODY, MA 01960-3840
(978) 548-5204
(978) 535-1934
Mailing address
200 CORPORATE PL, SUITE #8, PEABODY, MA 01960-3840
(978) 548-5204
(978) 535-1934
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
MA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9781129
—
MA
01
—
CYM16695
BLUE CROSS PROVIDER #
MA
Enumeration date
04/03/2007
Last updated
09/11/2025
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