Healthcare Provider Details

I. General information

NPI: 1942294772
Provider Name (Legal Business Name): PAUL GAGNE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CAMP ST
HYANNIS MA
02601-3063
US

IV. Provider business mailing address

800 DISTRICT AVE STE 530
BURLINGTON MA
01803-5062
US

V. Phone/Fax

Practice location:
  • Phone: 508-875-1984
  • Fax:
Mailing address:
  • Phone: 508-556-9150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number045106
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: