Provider Demographics
NPI:1063461408
Name:SAULS, RAYMOND KENNETH (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:KENNETH
Last Name:SAULS
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 1:382 FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:ASHBY
Mailing Address - State:MA
Mailing Address - Zip Code:01431-1936
Mailing Address - Country:US
Mailing Address - Phone:978-368-1227
Mailing Address - Fax:978-368-0507
Practice Address - Street 1:136 HIGH STREET EXT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:MA
Practice Address - Zip Code:01523-2056
Practice Address - Country:US
Practice Address - Phone:978-368-1227
Practice Address - Fax:978-368-0507
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76468207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F28261Medicare UPIN
3094774Medicare ID - Type Unspecified