Basic Information
| Provider Information | |||||||||
| NPI: | 1801970447 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH SUBURBAN HOSPITALISTS, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 91 STILES RD | ||||||||
| Address2: | ATTN SHARON SILVA | ||||||||
| City: | SALEM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030792846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038939784 | ||||||||
| FaxNumber: | 6038938886 | ||||||||
| Practice Location | |||||||||
| Address1: | 298 WASHINGTON ST | ||||||||
| Address2: | ADDISON-GILBERT HOSPITAL | ||||||||
| City: | GLOUCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019304832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9782834000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | NEWMAN | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9789223000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 9709100 | 05 | MA | MEDICAID |