Organization
SPRINGFIELD INTERNATIONAL HEALTH CENTER
Active
Organization
SPRINGFIELD INTERNATIONAL HEALTH CENTER
Active
Parent organization
PREVENTIVE MEDICINE ASSOCIATES,INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREVENTIVE MEDICINE ASSOCIATES,INC
Authorized official
DR. PUNYAMURTULA S KISHORE M.D. (PRESIDENT)
(617) 383-6567
Entity
Organization
Contact information
Practice address
11 KENT ST, BROOKLINE, MA 02445-7901
(617) 383-6567
(617) 383-6664
Mailing address
760 CHESTNUT ST, SPRINGFIELD, MA 01107-1614
(413) 214-7486
(413) 214-7499
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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