Provider Demographics
NPI:1558587006
Name:CONCORD CARDIOLOGY, PC
Entity Type:Organization
Organization Name:CONCORD CARDIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJUM
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-287-0021
Mailing Address - Street 1:131 OLD ROAD TO 9 ACRE COR
Mailing Address - Street 2:JCB STE 520
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4181
Mailing Address - Country:US
Mailing Address - Phone:978-287-0021
Mailing Address - Fax:978-287-0155
Practice Address - Street 1:131 OLD ROAD TO 9 ACRE COR
Practice Address - Street 2:JCB STE 520
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-287-0021
Practice Address - Fax:978-287-0155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9729178Medicaid
MAM18595OtherBCBS MA
MAM21456Medicare ID - Type Unspecified