MEDICARE: TIMOTHY DRURY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	MD04891	RI

General Provider Information

NPI Number	:	1407825904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY DRURY M.D.

Provider Business Mailing Address
First Line	:	275 MARTINE ST
Second Line	:	SUITE 301
City	:	FALL RIVER
State	:	MA
Zip	:	02723-1516
Country	:	US
Telephone Number	:	508-675-7535
Fax Number	:	508-675-7905

Provider Business Practice Location Address
First Line	:	100 KENYON AVE
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4216
Country	:	US
Telephone Number	:	508-675-7535
Fax Number	:	508-675-7905

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	07/08/2007

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Directions to “ TIMOTHY DRURY M.D.” Practice Location

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