John L Eten, MD

Individual provider Active NPI Family Medicine Physician · Orleans, MA

NPI 1649239757 · NPPES record last updated Jun 29, 2010

Key facts

NPI
1649239757
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
51173 (MA)
Practice address
204 Main St
Orleans Medical Center, P.C.
Orleans, MA 02653-3428
Phone
(508) 255-8825
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51173 MA Yes

Addresses

Primary practice location

204 Main St
Orleans Medical Center, P.C.
Orleans, MA 02653-3428

Mailing address

204 Main St
Orleans Medical Center, P.C.
Orleans, MA 02653-3428
Phone (508) 255-8825

Other identifiers

IdentifierTypeStateIssuer
01-00821OtherUNITED HEALTHCARE
6185932MedicaidMA
723878OtherTUFTS HEALTHCARE
B10436901OtherCIGNA HEALTHCARE
000000031977OtherBOSTON MEDICAL HEALTHNET
28599OtherMACHILDREN'S MEDICAL SECURI
7725OtherHARVARDPILGRIM HEALTHCARE
080130572OtherRAIL ROAD MEDICARE
J03410OtherMABLUE CROSS BLUE SHIELD

Other providers in Orleans, MA

All providers in Orleans, MA · Family Medicine Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.