Provider Demographics
NPI:1558406512
Name:VALLEY MEDICAL GROUP, P.C.
Entity Type:Organization
Organization Name:VALLEY MEDICAL GROUP, P.C.
Other - Org Name:VALLEY MEDICAL GROUP PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-772-3313
Mailing Address - Street 1:PO BOX 5700
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-5700
Mailing Address - Country:US
Mailing Address - Phone:866-431-4077
Mailing Address - Fax:413-774-7448
Practice Address - Street 1:329 CONWAY ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1526
Practice Address - Country:US
Practice Address - Phone:413-774-6301
Practice Address - Fax:413-774-6528
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY MEDICAL GROUP, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-20
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA683464OtherTUFTS HEALTH PLAN
MA9787151Medicaid
MAY61239OtherBLUE CROSS BLUE SHIELD OF
MA712451OtherCONNECTICARE, INC.
MA24189OtherHEALTH NEW ENGLAND
MA626166OtherHARVARD PILGRIM HEALTH PL
MA683464OtherTUFTS HEALTH PLAN