Provider Demographics
NPI:1568464881
Name:ESTELLA, NONNIE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:NONNIE
Middle Name:MARIE
Last Name:ESTELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RESEARCH PL
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2456
Mailing Address - Country:US
Mailing Address - Phone:978-459-8300
Mailing Address - Fax:978-459-8303
Practice Address - Street 1:10 RESEARCH PL
Practice Address - Street 2:SUITE 205
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2456
Practice Address - Country:US
Practice Address - Phone:978-459-8300
Practice Address - Fax:978-459-8303
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA160769207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG54086Medicare UPIN
MAA29947Medicare ID - Type Unspecified