1750346623 NPI number — DR. BETH A BIGGEE M.D.

Table of content: DR. BETH A BIGGEE M.D. (NPI 1750346623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750346623 NPI number — DR. BETH A BIGGEE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIGGEE
Provider First Name:
BETH
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750346623
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
575 TURNPIKE ST
Provider Second Line Business Mailing Address:
SUITE 11
Provider Business Mailing Address City Name:
NORTH ANDOVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01845-5924
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-794-1946
Provider Business Mailing Address Fax Number:
978-975-3925

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
323 LOWELL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANDOVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01810-4659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-794-1946
Provider Business Practice Location Address Fax Number:
978-975-3925
Provider Enumeration Date:
04/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  14580 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RR0500X , with the licence number: 214034 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001301901 . This is a "MEDICARE PTAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110083792A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001301902 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30209065 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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