Organization
NORTH SHORE GERIATRIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH J CHAMPNEY M.D. (PHYSICIAN)
(978) 469-0649
Entity
Organization
Contact information
Practice address
75 BRIMBAL AVE, BEVERLY, MA 01915-6009
(978) 469-0649
Mailing address
100 CUMMINGS CTR STE 232C, BEVERLY, MA 01915-6126
(978) 998-6799
(978) 998-6803
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
60080
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M19173
BLUE SHIELD
MA
Enumeration date
01/26/2007
Last updated
08/22/2020
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