| Baystate Medical Practices, Inc | |
|
759 Chestnut St Springfield MA 01199-1001 | |
| (413) 794-5700 | |
| (413) 794-1629 |
| Full Name | Baystate Medical Practices, Inc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 759 Chestnut St, Springfield, Massachusetts |
| Authorized Official Name and Position | Randall L Vaill (MANAGER PROVIDER ENROLLMENT) |
| Authorized Official Contact | 4137947976 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baystate Medical Practices, Inc 280 Chestnut St 2nd Floor Springfield MA 01199-1000 Ph: (413) 794-5700 | Baystate Medical Practices, Inc 759 Chestnut St Springfield MA 01199-1001 Ph: (413) 794-5700 |
| NPI Number | 1417013830 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 02/26/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417013830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207P00000X | Emergency Medicine | (* (Not Available)) | Primary |
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