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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