Organization
PEABODY OBGYN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
N LUISA KONTOULES MD (OWNER/PRESIDENT)
(978) 538-5380
Entity
Organization
Contact information
Practice address
6 ESSEX CENTER DR, SUITE 206, PEABODY, MA 01960-2910
(978) 538-5380
(978) 538-5385
Mailing address
6 ESSEX CENTER DR, SUITE 206, PEABODY, MA 01960-2910
(978) 538-5380
(978) 538-5385
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
12345
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9718010
—
MA
Enumeration date
07/19/2005
Last updated
07/18/2007
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