| Dr Stephen M Dierks, MD | |
| 250 Green St Ste 104, Gardner, MA 01440-1377 | |
| (978) 669-5522 | |
| (978) 669-5521 | 
| Full Name | Dr Stephen M Dierks | 
|---|---|
| Gender | Male | 
| Speciality | Urology | 
| Location | 250 Green St Ste 104, Gardner, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1508857731 | NPI | - | NPPES | 
| 3157695 | Medicaid | MA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208800000X | Urology | 150601 (Massachusetts) | Primary | 
| Entity Name | Henry Heywood Memorial Hospital | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1205823879 PECOS PAC ID: 1658262605 Enrollment ID: O20040322000360 | 
| Entity Name | Heywood Medical Group Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1699762286 PECOS PAC ID: 6901882836 Enrollment ID: O20040629001351 | 
| Entity Name | Skilled Facility Health Care Solutions Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1104018423 PECOS PAC ID: 9032299144 Enrollment ID: O20190416001569 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Stephen M Dierks, MD Po Box 1327, Laconia, NH 03247-1327 Ph: (603) 524-3211 | Dr Stephen M Dierks, MD 250 Green St Ste 104, Gardner, MA 01440-1377 Ph: (978) 669-5522 | 
| Dr. Francis Anthony Garofalo, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 250 Green St, Suite 210, Gardner, MA 01440 Phone: 978-669-5522 Fax: 978-669-5521 |