Healthcare Provider Details

I. General information

NPI: 1245615285
Provider Name (Legal Business Name): PIONEER CONTINUING CARE PROVIDERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 02/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 STAFFORD ST SUITE 200
SPRINGFIELD MA
01104-4110
US

IV. Provider business mailing address

300 STAFFORD ST SUITE 200
SPRINGFIELD MA
01104-4110
US

V. Phone/Fax

Practice location:
  • Phone: 413-452-6100
  • Fax: 413-452-6200
Mailing address:
  • Phone: 413-452-6100
  • Fax: 413-452-6200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID MCDOUGALL
Title or Position: PRESIDENT
Credential: D.O.
Phone: 413-452-6100