Provider Demographics
NPI:1962699157
Name:POIRIER, MAURICE DOUGLASS (MD)
Entity type:Individual
Prefix:
First Name:MAURICE DOUGLASS
Middle Name:
Last Name:POIRIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BLITHEWOOD AVE
Mailing Address - Street 2:APT. NO. 305
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-3543
Mailing Address - Country:US
Mailing Address - Phone:617-654-7485
Mailing Address - Fax:
Practice Address - Street 1:110 CHAUNCY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1720
Practice Address - Country:US
Practice Address - Phone:617-654-7485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA46030207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine