1649221599

Everything you always wanted to know about DEMERS K DIANNE PA but were afraid to ask.

DEMERS K DIANNE PA

You can also download the this 1649221599 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential
DEMERS K DIANNE PA
Gender:
Female
Enumeration date:
2006-05-15
Last update date:
2015-04-24
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
Search for DIANNE, DEMERS in
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Identifiers

identifier description issuer state
042472266 Other TRICARE CHAMPUS none
8301692 Other EVERCARE none
42523 Other HEALTHY START none
381306 Other MVP HEALTH CARE none
42523 Other CHILDRENS MEDICAL SECURIT none
67868 Other FALLON COMMUNITY HEALTH P none
AP2101 Other MEDICARE B none
042472266 Other THREE RIVERS none

Taxonomies

Taxonomy State License Number Primary?
363A00000X Physician Assistant MA 1183 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 5087566324
Practice Location Address Telephone Number 5087566324

Addresses

Type Address City State Postal Country
Mailing Address 390 MAIN ST STE 509 WORCESTER MA 1608 MA
Practice Location Address 26 QUEEN ST WORCESTER MA 1610 MA

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26 QUEEN ST MA WORCESTER
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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