Provider Demographics
NPI:1659583896
Name:CAPE COD EAR NOSE AND THROAT SPECIALISTS HEAD AND NECK SURGERY PC
Entity Type:Organization
Organization Name:CAPE COD EAR NOSE AND THROAT SPECIALISTS HEAD AND NECK SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT MD
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-790-0611
Mailing Address - Street 1:65 CEDAR STREET
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3009
Mailing Address - Country:US
Mailing Address - Phone:508-790-0611
Mailing Address - Fax:508-790-0589
Practice Address - Street 1:65 CEDAR STREET
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3009
Practice Address - Country:US
Practice Address - Phone:508-790-0611
Practice Address - Fax:508-790-0589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9764631Medicaid
MA9764631Medicaid