Tilles, Dan S

Tilles, Dan S is an individual health care provider with primary practice located at 86 Baker Ave Extension , Concord MA 01742-2125. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tilles, Dan S can be contacted via phone (978) 287-9300.

Contact Information

Primary practice address
86 Baker Ave Extension Concord MA 01742-2125
Phone: (978) 287-9300
Fax: (978) 287-9357
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 45946 Massachusetts

Profile Details

NPI number 1912964321
LBN Legal business name Tilles, Dan S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2006
Last updated May 26th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912964321 NPPES
Massachusetts MEDICAID 0172723
Massachusetts Other J07305
Massachusetts Other 65067
Massachusetts Other 006170
Massachusetts Other 4109369
Massachusetts Other 715989
Massachusetts Other B10208102

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