Provider Demographics
NPI:1699950659
Name:CAPE COD INTERNAL MEDICINE
Entity type:Organization
Organization Name:CAPE COD INTERNAL MEDICINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ZENGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-778-6363
Mailing Address - Street 1:35 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3009
Mailing Address - Country:US
Mailing Address - Phone:508-778-6363
Mailing Address - Fax:508-778-6677
Practice Address - Street 1:35 CEDAR STREET
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-778-6363
Practice Address - Fax:508-778-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6169295Medicaid
MA6169295Medicaid