Provider Demographics
NPI:1477530921
Name:NEUROSURGEONS OF CAPE COD PC
Entity Type:Organization
Organization Name:NEUROSURGEONS OF CAPE COD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOULE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-771-0006
Mailing Address - Street 1:46 NORTH ST
Mailing Address - Street 2:4
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3845
Mailing Address - Country:US
Mailing Address - Phone:508-771-0006
Mailing Address - Fax:508-790-8337
Practice Address - Street 1:46 NORTH ST
Practice Address - Street 2:4
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3845
Practice Address - Country:US
Practice Address - Phone:508-771-0006
Practice Address - Fax:508-790-8337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA611736Medicaid
MAM12830Medicare ID - Type Unspecified