Organization
MAYFLOWER INPATIENT PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PROVASNIK (SUPERVISOR OF PROVIDER ENROLLMENT)
(800) 355-0808
Entity
Organization
Contact information
Practice address
70 EAST ST, METHUEN, MA 01844-4597
(978) 687-0151
Mailing address
PO BOX 41610, PHILADELPHIA, PA 19101-1610
(800) 355-0808
(215) 834-2862
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9730770
—
MA
Enumeration date
07/05/2007
Last updated
08/22/2020
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