Provider Demographics
NPI:1740364983
Name:PIKUS, ANTHONY A (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:A
Last Name:PIKUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:152 CONANT STREET
Mailing Address - Street 2:LAHEY BEVERLY
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2511
Mailing Address - Country:US
Mailing Address - Phone:978-927-1919
Mailing Address - Fax:978-927-6102
Practice Address - Street 1:152 CONANT STREET
Practice Address - Street 2:LAHEY BEVERLY
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2511
Practice Address - Country:US
Practice Address - Phone:978-927-1919
Practice Address - Fax:978-927-6102
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2016-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA74643207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110050273AMedicaid
MAE98840Medicare UPIN
MAJ11617Medicare ID - Type Unspecified