Provider Demographics
NPI:1881938504
Name:SM CARDIOLOGY,PLLC
Entity type:Organization
Organization Name:SM CARDIOLOGY,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNIT
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKHERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-687-4140
Mailing Address - Street 1:217 SUTTON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1639
Mailing Address - Country:US
Mailing Address - Phone:978-687-4140
Mailing Address - Fax:978-327-5196
Practice Address - Street 1:217 SUTTON ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1639
Practice Address - Country:US
Practice Address - Phone:978-687-4050
Practice Address - Fax:978-327-5196
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNIT MUKHERJEE, MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76567207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9721240Medicaid
MA9721240Medicaid
MAM21293Medicare PIN