Provider Demographics
NPI:1164758439
Name:NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS GROUP
Entity Type:Organization
Organization Name:NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS GROUP
Other - Org Name:NORTHERN BERKSHIRE GENERAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PHYSICIANS SERVICES AND BUSINES
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CALWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-664-5508
Mailing Address - Street 1:71 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2504
Mailing Address - Country:US
Mailing Address - Phone:413-664-5999
Mailing Address - Fax:413-663-7257
Practice Address - Street 1:77 HOSPITAL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2550
Practice Address - Country:US
Practice Address - Phone:413-664-5999
Practice Address - Fax:413-663-7257
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN BERKSHIRE HEALTHCARE PHYSICANS GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty