Provider Demographics
NPI:1144732090
Name:PRIMARY CARE OF CAPE COD PC
Entity type:Organization
Organization Name:PRIMARY CARE OF CAPE COD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-418-6600
Mailing Address - Street 1:89 LEWIS BAY RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5240
Mailing Address - Country:US
Mailing Address - Phone:508-418-6600
Mailing Address - Fax:508-796-2177
Practice Address - Street 1:89 LEWIS BAY RD UNIT 4
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5240
Practice Address - Country:US
Practice Address - Phone:508-418-6600
Practice Address - Fax:508-796-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty