Provider Demographics
NPI:1265749907
Name:ENT NORWOOD LLC
Entity type:Organization
Organization Name:ENT NORWOOD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-769-8910
Mailing Address - Street 1:825 WASHINGTON ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3441
Mailing Address - Country:US
Mailing Address - Phone:781-769-8910
Mailing Address - Fax:781-255-9807
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:SUITE 310
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:781-769-8910
Practice Address - Fax:781-255-9807
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENT SPECIALISTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty