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General NPI Number Information
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NPI Number | 1073664033
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Entity Type | Individual
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Provider Name | DIEDERIK FREDERIK MEURSING M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 326 NICHOLS RD
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City | FITCHBURG
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State | MA
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Zip | 01420-1914
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Country | US
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Telephone | 978-878-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 1 PLEASANT ST APT 8-1
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City | WESTFORD
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State | MA
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Zip | 01886-2376
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Country | US
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Telephone | 918-616-0398
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 24935
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-41597
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 24935
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 246721
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License Number State | MA
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