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NPI 1598779860

NPI 1598779860 : PAUL A. COURNOYER D.P.M., P.C. : WORCESTER, MA

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General NPI Number Information
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    NPI Number           |    1598779860
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    Entity Type          |    Organization 
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    Legal Business Name  |    PAUL A. COURNOYER D.P.M., P.C. 
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Dates
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    Enumeration Date     |    07/29/2006
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    Last Update Date     |    01/21/2011
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Provider Practice Location Address
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    Address Line         |    123 SUMMER ST SUITE 550
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    City                 |    WORCESTER
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    State                |    MA
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    Zip                  |    01608-1216
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    Country              |    US
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    Telephone            |    508-363-6868
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    Fax                  |    508-363-6866
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Provider Business Mailing Address
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    Address Line         |    5 HEMLOCK CIR 
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    City                 |    SHREWSBURY
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    State                |    MA
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    Zip                  |    01545-1572
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. PAUL A COURNOYER 
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    Credential           |    M.D.
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    Telephone            |    508-363-6868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213ES0131X
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    Taxonomy Name        |    Foot Surgery Podiatrist
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    License Number       |    1864
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    License Number State |    MA
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