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NPI Code Detail

MEDICARE: DR. LAURIE A. DIMARIA MD

MEDICARE: DR. LAURIE A. DIMARIA MD
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
1207Q00000XFamily Medicine Physician75508MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1710638OTHERMAHARVARD PILGRIM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3J12414OTHERMABLUE CROSS BLUE SHIELD
4075508OTHERMATUFTS HEALTH PLAN

General Provider Information

NPI Number : 1437136413
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURIE A. DIMARIA MD
Provider Business Mailing Address
First Line : 28 RIVERSIDE DR
Second Line :
City : PEMBROKE
State : MA
Zip : 02359-1937
Country : US
Telephone Number : 781-826-8065
Fax Number : 781-826-8043
Provider Business Practice Location Address
First Line : 28 RIVERSIDE DR
Second Line :
City : PEMBROKE
State : MA
Zip : 02359-1937
Country : US
Telephone Number : 781-826-8065
Fax Number : 781-826-8043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2005
Last Update Date : 06/19/2008

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Directions to “ DR. LAURIE A. DIMARIA MD” Practice Location

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