Healthcare Provider Details

I. General information

NPI: 1598759367
Provider Name (Legal Business Name): PAUL F POULIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL F POULIN M.D.

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 BROWN ST SUITE #401
HAVERHILL MA
01830-6778
US

IV. Provider business mailing address

3 ELECTRONICS AVE STE 201
DANVERS MA
01923-1099
US

V. Phone/Fax

Practice location:
  • Phone: 978-521-8590
  • Fax: 978-521-8732
Mailing address:
  • Phone: 978-750-0300
  • Fax: 978-279-1324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number9050
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: