Healthcare Provider Details

I. General information

NPI: 1144334038
Provider Name (Legal Business Name): PAULO C ANDRE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 PONDVIEW RD
SUDBURY MA
01776-2542
US

IV. Provider business mailing address

48 PONDVIEW RD
SUDBURY MA
01776-2542
US

V. Phone/Fax

Practice location:
  • Phone: 800-634-4731
  • Fax:
Mailing address:
  • Phone: 800-634-4731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number210282
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: