MEDICARE: GRANT PIERRE 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	207QS0010X	Sports Medicine (Family Medicine) Physician	283910	MA
2	207Q00000X	Family Medicine Physician	283910	MA
3	207Q00000X	Family Medicine Physician	BP10057233	TX

General Provider Information

NPI Number	:	1730538604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRANT PIERRE M.D.

Provider Business Mailing Address
First Line	:	3 WALTER ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-1031
Country	:	US
Telephone Number	:	774-275-3367
Fax Number	:	508-519-0577

Provider Business Practice Location Address
First Line	:	35 HARVARD ST STE 104
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-2828
Country	:	US
Telephone Number	:	774-275-3367
Fax Number	:	508-519-0577

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

Provider Enumeration Date	:	06/10/2016
Last Update Date	:	06/29/2026

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