Provider Demographics
NPI:1184615957
Name:WINTERKORN, ELISABETH BEATRICE (MD)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:BEATRICE
Last Name:WINTERKORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PLACE LN
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-2928
Mailing Address - Country:US
Mailing Address - Phone:781-935-7614
Mailing Address - Fax:
Practice Address - Street 1:477 ANDOVER ST
Practice Address - Street 2:CHILDREN'S MEDICAL OFFICE OF NORTH ANDOVER
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5036
Practice Address - Country:US
Practice Address - Phone:978-975-3355
Practice Address - Fax:978-975-3510
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222508208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics