Basic Information
| Provider Information | |||||||||
| NPI: | 1477553287 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTEGRATED GASTROENTEROLOGY CONSULTANTS, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 RESEARCH PL | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | NORTH CHELMSFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018632412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784596737 | ||||||||
| FaxNumber: | 9784592580 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 RESEARCH PL | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | NORTH CHELMSFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018632412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784596737 | ||||||||
| FaxNumber: | 9784592580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | MARINELLI | ||||||||
| AuthorizedOfficialFirstName: | FRANKLIN | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9784596737 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 01/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.