Provider Demographics
NPI:1740410133
Name:SEACOAST EMERGENCY PHYSICIANS PC
Entity Type:Organization
Organization Name:SEACOAST EMERGENCY PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:KOLM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-742-5252
Mailing Address - Street 1:PO BOX 845398
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-5398
Mailing Address - Country:US
Mailing Address - Phone:877-485-4474
Mailing Address - Fax:
Practice Address - Street 1:65 CALEF HWY
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:NH
Practice Address - Zip Code:03861-6703
Practice Address - Country:US
Practice Address - Phone:603-868-8507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty