Provider Demographics
NPI:1730136409
Name:CAPE COD ARTHRITIS AND RHEUMATIC DISEASE, INC.
Entity type:Organization
Organization Name:CAPE COD ARTHRITIS AND RHEUMATIC DISEASE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:TROUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-790-2619
Mailing Address - Street 1:700 ATTUCKS LN
Mailing Address - Street 2:UNIT 2A
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1811
Mailing Address - Country:US
Mailing Address - Phone:508-790-2619
Mailing Address - Fax:508-790-8149
Practice Address - Street 1:700 ATTUCKS LN
Practice Address - Street 2:UNIT 2A
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1811
Practice Address - Country:US
Practice Address - Phone:508-790-2619
Practice Address - Fax:508-790-8149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81108207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0004020Medicare PIN