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General NPI Number Information
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NPI Number | 1609819234
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Entity Type | Individual
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Provider Name | PAUL A. COURNOYER D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 04/25/2016
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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 | 508-845-2711
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Fax | 508-363-6866
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 1864
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License Number State | MA
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