Provider Demographics
NPI:1114911757
Name:COUTU, PAUL R (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:COUTU
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1 PEARL ST
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2864
Mailing Address - Country:US
Mailing Address - Phone:508-897-6200
Mailing Address - Fax:508-897-6321
Practice Address - Street 1:1 PEARL ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2864
Practice Address - Country:US
Practice Address - Phone:508-897-6200
Practice Address - Fax:508-897-6321
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2011-01-21
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Provider Licenses
StateLicense IDTaxonomies
MA42565207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine