Provider Demographics
NPI:1932326949
Name:FALMOUTH PEDIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:FALMOUTH PEDIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:T
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-540-1801
Mailing Address - Street 1:2 BRAMBLEBUSH PARK
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540
Mailing Address - Country:US
Mailing Address - Phone:508-540-1801
Mailing Address - Fax:508-540-6595
Practice Address - Street 1:2 BRAMBLEBUSH PARK
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2325
Practice Address - Country:US
Practice Address - Phone:508-540-1801
Practice Address - Fax:508-540-6595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9708316Medicaid
MAD88580Medicare UPIN
MDG10519Medicare UPIN
MAH43837Medicare UPIN