Basic Information
Provider Information
NPI: 1386759348
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PEARCE
FirstName: LINDSAY
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2527 CRANBERRY HIGHWAY
Address2: ATTN: PROVIDER RELATIONS DEPT.
City: WAREHAM
State: MA
PostalCode: 025711046
CountryCode: US
TelephoneNumber: 8008415200
FaxNumber: 5082731241
Practice Location
Address1: 85 HERRICK STREET
Address2: RADIOLOGY DEPARTMENT
City: BEVERLY
State: MA
PostalCode: 019151790
CountryCode: US
TelephoneNumber: 9789223000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/20/2006
LastUpdateDate: 07/23/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X228469MAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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