Healthcare Provider Details

I. General information

NPI: 1689886913
Provider Name (Legal Business Name): PAUL HESS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ELM ST
DEDHAM MA
02026-4530
US

IV. Provider business mailing address

77 WOLCOTT AVE
DARTMOUTH MA
02747-2459
US

V. Phone/Fax

Practice location:
  • Phone: 781-326-3800
  • Fax:
Mailing address:
  • Phone: 508-999-1502
  • Fax: 508-992-0016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number125988
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: