Elizabeth C Coughlin, NP
Individual provider Active NPI Pediatrics Physician · Wareham, MA
NPI 1124214572 · NPPES record last updated Sep 19, 2007
Key facts
- NPI
- 1124214572
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 253690 (MA)
- Practice address
- 53 Marion Road
Suite One
Wareham, MA 02571 - Phone
- (508) 295-8622
- Fax
- (508) 295-4909
- NPI assigned
- Sep 19, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 253690 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wareham Pediatric Associates PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- ecoughlin7109@direct.chppoc.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 253690 | MA | Yes |
Addresses
Primary practice location
53 Marion Road
Suite One
Wareham, MA 02571
Mailing address
53 Marion Road
Suite One
Wareham, MA 02571
Phone (508) 295-8622
Other providers in Wareham, MA
- Natia Corsi
- David Daniel Costa
- Hillary Costa
- Matthew J Costa
- Khoryn Cote
- Danielle Crabb
- Nichole Aline Cross
- Jeremy Eric Cunningham-Allbert
- Current Medical Technologies Incorporated
- CVS Pharmacy Inc
All providers in Wareham, MA · Pediatrics Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.