Provider Demographics
NPI:1811052954
Name:WINCHESTER OB GYN ASSOCIATES, PC
Entity type:Organization
Organization Name:WINCHESTER OB GYN ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:DRUGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-721-4701
Mailing Address - Street 1:1021 MAIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1942
Mailing Address - Country:US
Mailing Address - Phone:781-721-4701
Mailing Address - Fax:
Practice Address - Street 1:1021 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1942
Practice Address - Country:US
Practice Address - Phone:781-721-4701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA600472OtherTUFTS
MAM14998OtherBCBS OF MA
MACM6107Medicare PIN
MAM14998OtherBCBS OF MA