| John L Maddox, MD | |
| 
					500 Salem St, Wilmington, MA 01887-1200  | |
| (978) 988-6209 | |
| (978) 988-6139 | 
| Full Name | John L Maddox | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics | 
| Location | 500 Salem St, Wilmington, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1801887229 | NPI | - | NPPES | 
| 0149110 | Medicaid | MA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 211906 (Massachusetts) | Primary | 
| Entity Name | Mass General Brigham Community Physicians Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1891112637 PECOS PAC ID: 1759273436 Enrollment ID: O20150723007726  | 
| Mailing Address | Practice Location Address | 
|---|---|
| John L Maddox, MD 122 Lakeview Ave, Haverhill, MA 01830-2716 Ph: (978) 988-6209  | John L Maddox, MD 500 Salem St, Wilmington, MA 01887-1200 Ph: (978) 988-6209  | 
Sandy Stephens, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 500 Salem St, Wilmington, MA 01887 Phone: 978-988-6209 Fax: 978-988-6139  | |
Mrs. Gayathry Sooriyakumar Nene, D.O Pediatrics Medicare: Medicare Enrolled Practice Location: 500 Salem St, Wilmington, MA 01887 Phone: 978-988-6200  | |
Normand A Tanguay, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 500 Salem St, Wilmington, MA 01887 Phone: 978-988-6209 Fax: 978-988-6139  | |
Carolyn J Sedor, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 500 Salem St, Wilmington, MA 01887 Phone: 978-988-6209 Fax: 978-988-6139  | |
Daniel M Carson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 500 Salem St, Wilmington, MA 01887 Phone: 978-988-6209 Fax: 978-988-6139  | |
Sarah Andrew, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 500 Salem St, Wilmington, MA 01887 Phone: 978-988-6209 Fax: 978-988-6139  |